Social Advocacy

    Order Description     Social Advocacy-Seminar Posting #3 “Advocacy” can be defined as a wide range of activities undertaken in support of individuals, families, systems, communities, and issues. As nurses, we advocate for patient and employee safety, best practices in health care and improved health-care outcomes. Prepared for multiple roles, the APN has been educated as a direct care provider, researched, consultant, educator, administrator, and advocate. Although some nurses are actively engaged in the advocacy role, some have experienced barriers to becoming a voice to a cause or political position. For example, the nursing professional is a highly regulated profession and in some instances nurses must balance advocacy for patients with loyalty to their place of practice. “Policy” is a course of action taken by an individual or group dealing with a problem. The four components of the policy process include agenda setting, government response, policy and program implementation, and policy and program evaluation. Political analysis measures the outcome of a policy related to political, social, economic, legal, or ethical aspects of proposed policies. Nurses are in a unique position, because they know the health care system, their analysis of how policies will affect delivery of care is a skill that most policy makers do not possess. The most important health care policy passed in recent years, is the Patient Protection and Affordable Car Act (PPACA). As an APN, do you see yourself and your peers as a voice for patient advocacy? Describe political actions that you have supported through a professional organization, or either place of employment? Or describe a political action that you would like to see addressed by a professional organization, or place of employment? Describe the impact of PPACA on client care and advance practice nursing? Within the complex adaptive system associated with healthcare what are some of the legal, socioeconomic and political issues surrounding PPACA?   Social Advocacy Kate’s Discussion As nurses, we advocate on behalf of our patients as we are their voice through times of vulnerability and illness, ensuring their safety and right to appropriate care. Advocacy, identified by the American Nurses Association (ANA) as a responsibility of the professional nurse, is embedded in all aspects of our education and continues throughout our practice and career advancement (ANA, 2010). Therefore, we are responsible for staying current and knowledgable of hospital policies and procedures and are encouraged to participate in committees and organizations as we also advocate for ourselves and the nursing workforce. As we advance in our careers we appreciate the influential policies and reforms within the healthcare system as these affect our practice and the patients and communities we serve. Accounting for the largest number of employees in healthcare, nurses have the potential for great impact in policies and changes. Engaging in political processes to promote sound policy for nursing practice and healthcare is a direct extension of nurses’ role as patient advocates (Waddell, 2016). Advocacy requires working through formal, decision-making bodies to achieve desired outcomes and therefore requires us nurses to serve on committees, councils, and quality improvement teams to influence changes (Tomajan, 2012). Considering the current state of our healthcare system, the call for the nursing profession’s involvement in policy and advocacy is greater now than ever before. As the Patient Protection and Affordable Care Act (PPACA) implementation efforts highlight the importance of primary care and preventive services along with granting healthcare access to those previously uninsured or underinsured, the demand for and shortage of primary care providers continues to grow. This presents Advanced Practice Registered Nurses (APRNs) with opportunities to fill in the gaps as they are ideal candidates for these roles, possessing the educational preparation and competencies necessary to support and lead the transformation of healthcare to improve the public’s health. In order to meet the Triple Aim initiative of better care, better health, and lower cost, APRNs must utilize leadership skills to improve patient outcomes, create new care delivery models to meet increasing demands of services, and develop policies to enhance services and remove practice barriers (Lathrop & Hodnicki, 2014). While the nursing profession holds great power in numbers, APRNs are frequently overruled by those with greater authority such as physician organizations, presenting APRNs with challenges and barriers in allowing them to practice to their fullest potential. The IOM report identifies restrictive scope-of-practice regulations in some states as the most serious barrier to accessible care and that APRNs should be able to practice to the fullest extent of their education and training nation-wide (IOM, 2011). Physician related barriers reflect those that believe APRNs are unable to deliver the same quality of care as physicians. Barriers to successful collaboration between APRNs and physicians can be attributed to physicians lack of knowledge of APRNs scope-of-practice and the variations of those that exist state to state. The lack of collaborative models impedes effective teamwork necessary to achieve best practices and quality patient outcomes at a time of shortage in primary care providers (Hain & Fleck, 2014). Strict payer policies is another barrier attributing to limitations of APRNs independent practice as they are usually linked to state practice regulations and licensure. Lack of reimbursements impedes APRN’s ability to financially sustain primary care practices. While most states grant prescriptive privileges, they do not do the same for admitting privileges. Therefore, APNs cannot follow their patients when they are admitted into acute care facilities. This may interfere with continuity of care and care coordination which can ultimately have a negative impact on patient outcomes (Hain & Fleck, 2014). The nursing profession and the publics health is supported and advocated for by several national organizations such as the ANA. They provide us with resources and up-to-date information on health care reform and how these may have an impact on our practice. The ANA continues to advocate for high-quality, affordable healthcare for all as they oppose efforts to repeal the PPACA by providing a comprehensive health care plan embracing the following principles (ANA, 2017): 1. Protect Americans against being denied insurance coverage because of pre-existing conditions and provide access to affordable health insurance coverage plans 2. Promote and support cost-effective preventive health services 3. Embrace innovative health delivery models that encourage wellness, prevention, and coordinated care in order to bring down cost and make health insurance affordable for all 4. Build a workforce that meets the demand of a growing and challenging health care system and population While the public has recognized the nursing profession to be the most trusted within healthcare, the full potential for their influence has yet to be realized. This can be attributed to the current barriers and challenges presented. Historically, nurses have overcome many barriers as a profession as early nursing pioneers have paved the way for advancements in education and specialization roles. Presently, APRNs and their practice are impacted by several policy and regulation initiatives, most significantly including the Consensus Model for APRN Regulation: Licensure, Accreditation, Certification and Education; the Doctor of Nursing Practice movement; the IOM report; and the PPACA. While expansions in the APN role have been achieved, we still face major barriers to overcome, the largest being that of practicing to the fullest scope-of-practice nation-wide