The integration of more evidence into the healthcare system has complex political and regulatory ramifications because healthcare is one of the industries with the highest growth in developed nations. Technology and other evidence-based techniques are prevalent in modern healthcare, necessitating the implementation of regulations to safeguard both patients and healthcare professionals. analyzing a health or nursing profession public policy that requires change, The World Health Organization (2018) states that health policy refers to the actions and choices made to advance specific health objectives within a society.
Despite the fact that healthcare policies might concentrate on new issues like the usage of electronic health records and Medicare reimbursements, the problem of healthcare staffing may also call for policy modification or even the creation of new policies (Edmonson et al., 2017). A strategy to control nursing staffing can help to improve the quality of services offered to patients. Nursing staffing is one of the problems that the healthcare sector faces globally.
Issue of Public Policy
Due to an uneven distribution of the healthcare workforce, the nursing profession continues to have shortages. The scarcity of nurses can be considerably reduced by setting appropriate nurse-to-patient ratios in healthcare. Federal law 42CFR 482.23(b) mandates that hospitals qualified to participate in Medicare maintain an acceptable staffing level of licensed practical nurses, registered nurses, and other healthcare professionals to provide nursing care to all patients as necessary (Vogenberg & Santilli, 2019). Given that it is up to the states to choose the ratios and that there is no deadline for formulating the policy, this requirement does not necessarily provide a solution to the current problem. Currently, California is the only state with a law defining the minimum nurse-to-patient ratios that must always be maintained (Rosa et al., 2019). To ensure that every state complies with the federal criteria, a policy defining the minimum nurse-to-patient ratios in each state is necessary. There should also be a time limit.
The majority of health professionals are nurses, who play a crucial role in healthcare. The nurses are in charge of providing patients with high-quality medical treatment while guaranteeing their safety and wellbeing throughout their hospital stay. Unfortunately, the scarcity of nurses has continued to be a problem in healthcare for decades, and there are relatively few healthcare regulations available to control nurse-to-patient ratios (Vogenberg & Santilli, 2019). There is now no better way to address the nursing shortage than to create healthcare policies that address it. The nursing shortage is currently at the top of the developing trends in healthcare in the United States. To enable healthcare institutions to hire more nurses, there should be clear nurse-to-patient ratios in every state in the US. Second, the burden of chronic illnesses has grown, bringing more patients into healthcare facilities and increasing the need for in-patient treatment. Nurses are required to care for numerous patients, which can lead to exhaustion and potential work discontent (Shin et al., 2018). In order to control the number of patients that nurses can assist, policies must be created.
By 2035, the World Health Organization predicted there will be a shortfall of healthcare workers worldwide (Edmonson et al., 2017). The growing number of patients with chronic diseases, the aging population, and the shrinking healthcare personnel due to aging are all blamed for the shortage. According to these figures, nurses must care for more patients than necessary to satisfy the demand for their services. Nurses endure burnout without the right nurse-to-patient ratios being established, which lowers the standard of care (Vogenberg & Santilli, 2019). The American Nurses Association (ANA) is in favor of a legislative model that gives nurses the authority to design staffing plans that are unique to each unit in order to address the shortfall. Evidence suggests that maintaining appropriate nurse-to-patient ratios improves patient safety, decreases medical errors, and lowers patient care costs by preventing or reducing readmissions (Rosa et al., 2019). For the finest care to be given and to get the most out of nurses, the right ratios must be established.
A hospital’s bottom line is increasingly affected by negative outcomes connected to understaffing since quality is becoming more and more correlated with financial health. In order to develop policies about acceptable nurse-to-patient ratios, it will be necessary to invest in nurse recruitment, healthcare facility expansion, and employee training. Many states are apprehensive about boosting the nursing workforce to address the shortfall because of the additional costs that healthcare organizations will bear, according to Shin et al. (2018). However, after the strategy is put into place, hospitals would gain a lot of financial advantages. Patient satisfaction is increased when nurse-to-patient ratios are appropriate. Patient satisfaction is a key factor in the HCAHPS rankings, which determine whether hospitals receive more funding each year (Shin et al., 2018). Second, hospitals will gain from less expensive mistakes brought on by insufficient personnel while lowering the rate of readmissions. Hospitals will save more money that can be used for growth as a result of decreased errors and readmission rates. An rise in the patient population as a result of observed improvements in the standard of service and patient satisfaction is another potential effect (Vogenberg & Santilli, 2019). The patient demographic is changing, which means the healthcare industry will make more money.
Every nurse’s ambition is to see policies on appropriate nurse-to-patient ratios established across the nation. Fighting for the establishment of the policy as it is currently practiced in the state of California requires a lot of guts from nurses. I think there should be justice in both the way medical professionals provide care for patients and how services are provided to them. It is unfair that nurses must endure this for so long when staffing issues can be resolved. Due to understaffing, numerous nurses have experienced burnout, work unhappiness, and even mental illness. I adore being a nurse, and I want to see nurses work in a welcoming environment, giving excellent care, and leave the workplace in peace. I am adamant about pushing for this policy change because I think it will have a positive impact on the treatment provided to patients.
Principle or Theory of Ethics
A normative ethics theory called utilitarianism defines action in terms of right and wrong. Amer (2019) argues that an action is morally correct if it tends to increase happiness and is bad if it tends to reduce happiness for everyone involved, not just the action’s performer. According to my viewpoint on the policy change, it is appropriate to expand nurse staffing because doing so benefits the nurse as well as the patient. If adequate nurse-to-patient ratios are not established, the workload of nurses will continue to increase, which will cause burnout and other negative impacts. The most prevalent method of moral reasoning employed in business is utilitarianism because it takes into consideration costs and rewards (Amer, 2019). Who will gain from decisions should be taken into account, along with their financial implications. According to this hypothesis, changing US policy to establish appropriate nurse-to-patient ratios will help the healthcare industry over the long term.
Maker of decisions
The proposed regulation will be sent to Dr. Cara M. Christ, director of the Arizona Department of Health Services.
Top government leaders who possess the information, skills, and backing required for policy change must pay attention to the issue of healthcare. A new policy must also be passed through a legislative procedure, which takes time and a lot of pressure from political influencers. Dr. Christ is the recipient of the policy since she oversees the division of the Arizona Department of Health that deals with healthcare issues, including the creation of policies. I think she has dealt with complaints about the nursing shortage over her five years in the position, and possibly the department is working to increase nurse-to-patient ratios.
The importance of nurses in ensuring quality and safe treatment is widely acknowledged, and nurse staffing is a critical aspect of health policy. Research and policy publications like the IOM’s Err is Human study have prompted public and professional concerns about the quality of healthcare. Today, every healthcare business understands the value of staffing levels for healthcare workers in lowering errors and enhancing patient care. Although nurses make up the majority of the healthcare team in healthcare organizations, there is still a staffing shortage as a result of the rising patient population. More than 71 million Americans are above the age of 65, according to latest statistics. The workforce of healthcare professionals, notably nurses, needs to be improved due to the rise in elderly patients.
A greater emphasis on what constitutes a sufficient level of nurse staffing has emerged during the past few decades. Worldwide, organizations have concentrated on creating plans for safe staffing that will help improve hospital care. According to research, having the right nurse-to-patient ratios increases patient care, which lowers hospital mortality. According to a US systematic review, having more nurses on staff reduces the likelihood of in-hospital death (Driscoll et al., 2018). Additionally, because nurses have the time to analyze patient data and make the necessary decisions during care delivery, optimum nurse staffing ratios lower the frequency of medical errors.
Having the ideal number of staff members is crucial for delivering the greatest treatment and getting the most out of registered nurses. The significance of expanding the healthcare nursing workforce has been examined in studies including patients, providers, and organizations as a whole. Improved staffing ratios boost patient happiness and raise HCAHPS ratings, according to a significant discovery (Shin et al., 2018). When nurses take the time to talk with patients and listen to their concerns, patients report feeling better overall. Because of the paucity of nurses, some crucial nursing care processes are omitted, like bedside shift reporting. In these situations, communication is hampered, and patients are not satisfied with the nursing treatment (Driscoll et al., 2018). Poor results on the HCAHPS surveys as a result have an adverse effect on Medicare and Medicaid Services reimbursements.
Analysts have attempted to determine how nurse staffing influences the financial position of the company because it is currently the most prominent healthcare trend. Hospitals that are experiencing financial instability have tried to boost profitability by reducing nurse personnel. However, it has been discovered that nurse staffing increases healthcare businesses’ competitive edge, resulting in greater financial performance (Edmonson et al., 2017). The number of patients serviced in outpatient departments rises, waiting times drop, and there is more interaction between patients and nurses thanks to adequate staffing ratios. More patients visit the facility as a result of the increased patient satisfaction. Other research has revealed that better staffing boosts nurses’ job satisfaction and lowers turnover rates, which spares businesses time and money on new hiring (Shin et al., 2018). A policy reform to increase nurse-to-patient ratios may initially be expensive, but it may also have greater long-term advantages.
Healthcare coverage and the underlying cost of healthcare are the main topics in American healthcare policy. The utilization of health insurance and access are where the majority of issues with healthcare coverage are found. When it comes to cutting healthcare costs, the majority of corporations try to do so by lowering costs or by using less medical services (Rosa et al., 2019). With the US leading the globe in healthcare spending, policymakers are reportedly being cautious when it comes to spending money on healthcare. Because the new policies would have financial repercussions, state policies aimed at enhancing staffing are still pending. The absence of strong coordinated nursing leadership that can push for policy formulation locally and nationally is another issue that has been noted (Shin et al., 2018). Few political figures are knowledgeable in nursing policies, which leaves nursing unions to advocate for improved nurse-to-patient ratios.
Analyzing a health or nursing profession public policy that requires change Options/Interventions
Different ideas from policymakers have been put out to transform the healthcare industry. The suggested policy change could go one of the following three paths because there are numerous healthcare policies. First, the decision-maker may decide to disregard the suggested adjustment because of the methodology or because it lacks a strong foundation. Neglecting this policy change will make the quest for optimal nurse-to-patient ratios much more time-consuming. The policy-maker’s second choice is to accept the idea with a few modifications. The decision-maker might support a policy that addresses the nursing shortage while restricting ideas that would result in the hiring of more nurses. The final option is for the decision-maker to accept the suggested policy change and devise strategies for approaching other important stakeholders who might support the change.
Analyzing a health or nursing profession public policy that requires change, Plan of action
Setting the agenda and going through multiple state hearings are all steps in the process of developing policies, which eventually become laws. The designated decision-maker has the authority to present the state government with the agenda for hearings to support the proposed policy change. I would suggest that the decision-maker look to significant political figures and professional nursing groups for endorsement of the suggested policy change. The decision-maker could benefit immensely from the backing of groups like National Nurses United (NNU) and the American Nurses Association (ANA), both of which share the same goals. The decision-maker should have a competent team that will assess the financial ramifications of the policy, including weighing the benefits of making the policy change, in order to overcome the highlighted hurdles. The ability of nurses to enhance their political engagement and policy understanding in order to support such policies in the future will be key to long-term solutions to the healthcare policy reform.
Analyzing a health or nursing profession public policy that requires change, The Policy Brief’s success
Both short-term and long-term metrics will be used to assess the policy brief’s effectiveness. The decision-acceptance maker’s of the new policy will be a crucial step in determining whether the suggested remedy is implemented. After accepting, the decision-maker will need to enlist the aid of political figures and specialized groups. Their assistance will be invaluable in achieving the desired outcomes. Before becoming legislation, the policy change will also need to go through a number of steps. The state governor will have the last say on whether it can become a law if it makes it through the committee stage. The new policy will have a favorable effect on the HCAHPS scores with regard to the evaluation of long-term success. To demonstrate the efficacy of the policy adjustment, the state’s average HCAHPS score ought to rise.
Analyzing a health or nursing profession public policy that requires change, Identified Community or Organization
Through its nationwide initiative “The national campaign for safe Rn-to-patient staffing ratios,” the National Nurses United (NNU) expresses interest in the suggested legislative reform.
Analyzing a health or nursing profession public policy that requires change, Overview of Expressions of Interest
The National Nurses United is a professional group of nurses from all around the nation who run campaigns to advance a shared vision of collective action for nurses. These campaigns seek to advance the needs of US patients and direct care nurses. The nationwide campaign for safe staffing ratios, which details the suggested federal RN-to-patient safe staffing ratios, is one of these campaigns (NNU, 2020). The organization recognizes that every patient needs a uniformly high standard of care, which can be delivered by having enough nurses on staff. In addition, the union offers links to additional legislation that supports nurse staffing, such as Brown’s “The Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act – S.1357” (NNU, 2020). In order to pass safe staffing rules, the NNU is requesting the support of all nurses in the US through a collective effort to gain political clout.
The following CBPR tenets will be applied in collaboration with the National Nurses United.
a) CBPR encourages cooperative and just relationships throughout all research phases and uses a power-sharing and empowering process.
b) CBPR supports capacity building and co-learning among all partners.
c) For the mutual benefit of all partners, CBPR strikes a balance between research and action.
Analyzing a health or nursing profession public policy that requires change, Method and Cooperation
To contact the leaders and voice complaints, the National Nurse United has representatives in a number of states. The National Nurses Organizing Committee of Arizona will be the main point of contact with the group. The organization works closely with the department of health to achieve policy change and nursing quality improvement, so the decision-maker is in a better position to get in touch with them. To collect comments on the policy change on collaborative practice, frequent contact with the state committee will be kept up. The most effective way to get in touch with the organizational executives will be via email.
Analyzing a health or nursing profession public policy that requires change, Goal Alignment
By developing a national strategy on appropriate nurse-to-patient ratios, the policy change seeks to enhance nursing staffing. However, NNU’s objective is to increase the voice of direct care nurses and patients in public policy, which includes the implementation of safe nurse to patient ratios (NNU, 2020). By working with policymakers and planning awareness-raising efforts, the union is committed to assisting states with safe staffing. The organization was able to sponsor significant pieces of national legislation in its first year, including the successful California bill on RN-to-patient ratios.
Steps to Take
The first phase will involve conducting research to acquire data on the proposed policy change. The decision-maker can be persuaded that the new policy is necessary if they are provided with accurate information regarding the change. After data has been gathered, the decision-maker will be contacted, and a meeting will be set up to discuss the policy change. To further emphasize the necessity of the policy change, more backing from local organizations such as the hospital administration will be needed. The final step will be to get in touch with National Nurses United via the state committee and request their assistance in promoting the policy change.
With initiatives to enhance nurses’ interests, the National Nurses United seeks to establish a common vision of collective action for nurses. Through the negotiation of the greatest collective bargaining contracts and the sponsoring of legislation for nurses and patients, its members have earned a reputation as strong proponents of guaranteed healthcare (NNU, 2020). During the process of changing the policy, the NNU members will play a variety of functions, including capacity-building and problem-solving.
Identification of the issue, consideration of the options, and decision-making that will successfully address the issue are all part of problem-solving (Wallerstein et al., 2017). The NNU members will participate in policy analysis during the policy change to address any problems that might prevent the policy change. The team members will also attempt to resolve any communication issues that may develop as a result of sluggish procedures and potential misunderstandings between the policy makers and the team in charge of implementing the policy. A demonstrable increase in an organization’s capacity to carry out its mission through a combination of competent management, strong governance, and commitment to measuring and attaining results is referred to as capacity building (Wallerstein et al., 2017). By educating the implementation team on issues related to policy formation, collaboration during policy making, and future methods that can be used when advocating for policy change, the NNU members will endeavor to foster capacity building. The members will also act as a point of contact for other stakeholders in the area, such as policy change advocates, other groups with related interests, and government officials.
Essentials of an Evaluation Plan
The decision-and maker’s National Nurses United’s collaborative efforts will be highlighted in the assessment strategy for the policy change. First, CBPR incorporates an empowering and power-sharing approach and encourages cooperative and equitable partnerships throughout all research phases (Wallerstein et al., 2017). The efficiency of the two organizations’ cooperation will be assessed by looking at the meetings held and the continuity of communication throughout the formulation of policies. Facilitating co-learning and capacity building among all partners is the second CBPR principle (Wallerstein et al., 2017). While resolving any issues that might come up throughout the legislation process, NNU members will be involved in instructing and educating other members of the local organizations about the policymaking process. According to the third principle chosen, CBPR strikes a balance between research and action for the benefit of all partners (Wallerstein et al., 2017). The NNU and the decision-maker should exhibit thorough comprehension of the policy issue during the evaluation and be prepared to implement the suggested policy adjustment.
The NNU’s major responsibility will be to work with the decision-maker and other regional organizations to promote the policy change. Effective engagement with the other stakeholders, especially information sharing during the policymaking process, will be the key to success. The other parties must be able to show that they comprehend how policies are made and how to handle upcoming policy problems. Passage of the bill during committee hearings and, most likely, final passage of the measure as legislation will serve as additional indicators of the plan’s effectiveness.
Advantages of Each Method
Because managers have authority over workers and other important participants during the change process, the top-down approach is a systematic technique to implement change in businesses (Heyden et al., 2017). It is efficient in terms of cost and has a propensity to involve just key employees in the change process. The bottom-up method of managing change may be preferred by other managers since it is simpler to enlist partners and generate momentum for the change process. Additionally, effective communication with all members encourages participation and cooperation.
Problems with each Approach
Although the top-down strategy may be easy to apply, it does not take into account the opinions of other partners. As a result, it becomes challenging to involve other team members in change and may be impossible to stop the change process once it has started (Heyden et al., 2017). Because it involves numerous partners, it is recognized that the bottom-up strategy takes a lot of time. Additionally, it could take a long time and cost a lot of money to make the desired adjustment.
Most Powerful Method
I advise using a bottom-up strategy to tackle the chosen public policy issue. The National Nurses United members’ participation in the policy-making process is intended to provide local nurse leaders’ groups more authority to continue advocating for change. During the process of changing policies, it will be crucial to involve every member of the implementation team in order to learn and demonstrate collaborative practice according to the CBPR principles. The bottom-up strategy offers shared decision-making, which is necessary to deal with the suggested policy change.
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