Policy Weeks 11, 12 & 13

Policy Weeks 11, 12 & 13 What is advocacy? - Correct Answer to plead the cause of another What are nurses advocates for? (6) - Correct Answer - patients - families - nursing profession (by education and appealing to legislators and policymakers) - disease promotion - health promotion - access to health care How do nurses serve as advocates for the nursing profession? - Correct Answer educating and appealing to state and federal legislators and policymakers to promote safe workspaces for nurses and to safeguard the nursing scope of practice. Through the 1980s who were nurses suppose to be loyal to? - Correct Answer to their physician leaders, the primary goal of loyalty by nurses was to project and reinforce confidence in the health care enterprise. Nurses were taught that loyalty to the physician equated with faithfulness to the patient. What helped change nursing's role from loyalty to physicians to advocacy for patients? - Correct Answer A physician ordered a new graduate nurse, to administer cocaine injections, instead of procaine injections to a tonsillectomy patient. The nurse carried out the physician's order, resulting in the death of the patient. The physician was acquitted on all charges, but the nurses was found guilty of manslaughter for failing to question the orders of the physician. This case sparked worldwide protests from nurses and served to push nursing toward independent practice and accountability. Early forms of nursing advocacy borrowed heavily from ____________ models of advocacy and centered on ________________ and patient's _____________ - Correct Answer legal models, centered on consumerism and patient's rights The concept of "nurse as advocate for the patient" recognized the inherently oppressive nature of patienthood, wherein the patient is ______________ as a result of his or her illness and unable to care for himself or herself - Correct Answer vulnerable Why are nurses uniquely situated to advocate for patients? (2) - Correct Answer - because they spend the most time with patients and have an intimate connection with patients and their families - have the most influence over the patient's experience while the patient is hospitalized or ill What are the three types of nursing advocacy that influence policy, population health and the profession of nursing? - Correct Answer 1. issue advocacy 2. community and public health advocacy 3. professional advocacy What is an example of issue advocacy? - Correct Answer - mental health nurses are frequent advocates for programs and services - goal setting with these patients to integrate the into the community(cant be done without the existence of health care services and programs that support such integration) Issue advocacy occurs when nursing care of patients extends beyond _______________ - Correct Answer the hospital or clinic Issue advocacy directly promotes improved ___________________________, although it does not involve advocacy on the _________________________ - Correct Answer improved patient outcomes, does not advocate on behalf on any one individual How is issue advocacy best accomplished? - Correct Answer through the formation of coalition What does community and public health advocacy focus on? (2) - Correct Answer the social structures and behaviors that have a significant impact on health What are some health determinants that community and public health advocates look at? (4) - Correct Answer - quality of the environment - the nature of human relationships - the durability of the social infrastructure - the justice inherent in the social order How can nurses be community and public health advocates? - Correct Answer to work with communities to mitigate social determinants of illness and promote health ____________________ compose the largest segment of the health care workforce - Correct Answer nurses _____________________ deliver almost all of the care to patients in the hospital setting - Correct Answer nurses The amount and quality of nursing care that patients receive is directly related to a number of health _________________- - Correct Answer outcomes Professional advocacy involves examining what issues? (4) - Correct Answer - workplace safety - nurse/patient ratios - expanded scope of practice - limitations on malpractice liability Because nurses have a direct relationship to the health of patients, advocacy on behalf of the nursing profession is a powerful form of _________________ advocacy. - Correct Answer patient What are some barriers to advocacy? - Correct Answer - advocacy is time consuming - requires a significant commitment on the part of the nurse (energy) - lack of education and training about advocacy skills - fear of retribution Why might nurses be fearful of retribution if they do advocate? - Correct Answer advocacy, whether on behalf of patients or in support or opposition to issues, is typically associated with some degree of "rocking the boat." After all, if the status quo were effective, there would be no need for advocacy In order to become involved/politically savvy what do you need? - Correct Answer to have mentors (colleagues and friends) who are politically savvy How will mentors help us become involved/become politically savvy? (5) - Correct Answer - to teach - to believe in - to support - to celebrate our successes - help us learn from our failures What is the first step when getting involved in politics/policy? - Correct Answer - deciding how much energy and time one is willing to devote Success in the world of policy and politics demands the ______________ and __________ that nurses possess. - Correct Answer strengths and skills What is the critical first step towards becoming part of the policy solution? - Correct Answer realizing that a problem may be caused by a policy failure For example, lack of support staff on an acute care unit may be related to __________________ rather than an __________________________ - Correct Answer may be related to decreased reimbursement rates, rather than an uncaring hospital administration Emerging nurse leaders seeking to advance their careers and develop political skills should secure a _________________ relationship. - Correct Answer mentoring What is an example of collective mentoring? - Correct Answer Many state nursing associations are successfully reaching out to collectively mentor hundreds of nursing students through lobby days in national and state capitols. Nursing students and practicing nurses have many opportunities to experience collective mentoring in learning the political ropes through relationships with leaders and peers in organizations such as (4) - Correct Answer - the National Student Nurses Association - ANA - specialty and state nursing associations - volunteer health-related organization What is lobbying? - Correct Answer an attempt to shape policy and influence government by ensuring that key policymakers are aware of and understand the concerns of their constituents Who are lobbyists trying to influence? (3) - Correct Answer - policymakers - law makers - government officials Lobbying is a form of _______________ - Correct Answer advocacy Lobbying should not cause _____________ or ____________. Instead we need to do what? - Correct Answer should not cause fear or silence, instead we need to empower individuals to speak up and voice their opinions With the right combination of ______________, _____________________ and __________________ individual citizens can and do have access to and accountability from elected officials, - Correct Answer passion, knowledge, and commitment, What does the IRS say the difference between lobbying and advocacy is? - Correct Answer lobbyist "a person who represents the concerns or special interests of a particular group or organization in meetings with lawmakers" whereas citizen advocates are not paid and spend most of their time doing something else. Why do people lobby? - Correct Answer - because they see something that needs to be changed Unless a nurse represents their professional association as a paid lobbyist or serves as an appointed or elected representative, they often lobby because of their _________ and __________ - Correct Answer beliefs and values. What are the steps in effective lobbying? - Correct Answer 1. Research 2. Identify supporters 3. Contact policymakers What is involved in the research step of lobbying? - Correct Answer - to learn as much as you can about the issue so that you can decide what your best lobbying approach will be - Uncover the legislative history, stakeholders, important elected officials, and policy particulars of bills related to your issue of interest. What is involved in the identifying supporters step of lobbying? - Correct Answer First, identify members of Congress or state legislatures who have been leaders on the particular issue. When approaching the legislator for support, you will be able to build on his or her previous knowledge and initiatives to craft a workable legislative strategy. Remember to thank the legislator for their previous support. Once you identify the issue that you want to lobby on, and you have educated yourself as to its legislative history and the current status of bills related to it, the next step is to determine (1) whom you need to contact to bring about change and (2) the best mode of communication to accomplish that change. What is involved in the contacting policymakers step of lobbying? - Correct Answer Your first step at the federal 393level is to identify the person in your legislator's office who is responsible for your issue. For nursing and health-related issues, this will likely be the legislative assistant who works on health care policy. Sometimes, though, responsibility for health care issues can be divided among several staff, particularly if the member of Congress serves on a committee that has jurisdiction over health. Usually, the easiest way to identify the correct person on your issue is to telephone your member's Capitol Hill office and ask for the name of the individual who handles that issue. Once you have identified the proper staff member, you should address all correspondence or requests for meetings to that person. You should try to build relationships at all levels of the _____________________ - Correct Answer government What are the different ways of lobbying? (5) What is the most effective strategy? - Correct Answer - face-to-face (perceived as the most effective strategy) - email (norm- direct, timely, flexible, can have attachments) - telephone calls - letter writing - providing hearing testimony What are the disadvantages to writing a letter? - Correct Answer all mail delivered to Congress must go through an irradiation process. This process creates new compounds, which results in a different look, feel, and even smell. In many cases, it ruins the mail, rendering it virtually unreadable. What do legislators depend on lobbyist for? (3) - Correct Answer - to provide information about issues/concerns - support projects - help with campaigns What does the stepping out article say is the most valuable tool in the policy arena? - Correct Answer The most valuable tool in the policy arena is time. Decisions are made and influenced by the people who show up. If you feel passionate about something, become informed and show up. The stepping out article says that "decisions are made and influence by the people who _______________" - Correct Answer show up What does the stepping out article say are the three most important steps to organizing action? - Correct Answer 1. Network/coordinate with other professionals who have similar concerns and messages 2. Develop a brief, concise message for legislators and their staff 3. Understand the timing- there are critical moments for delivering our messages, and understanding when and how these moments occur is one of the most important make-or-break steps. What is an interest group? - Correct Answer a collection of people who pursue their common interests by influencing political processes. What are interest groups also known as? - Correct Answer factions, special interests, pressure groups, organized interests What role do interest groups have on health care reform? (2) - Correct Answer - can influence policy development - empower the citizens What methods do interest groups use to advance their causes? (5) - Correct Answer - lobbying - grassroots mobilization - influencing elections - shaping public opinion - litigation Lobbying involves __________ influence of public officials and their decisions - Correct Answer direct What does lobbying involve? (4) - Correct Answer education, shaping opinions, and offering data and analyses ___________________ often assist in bill drafting and revision - Correct Answer lobbyists Grassroots mobilization involves ________________ influencing officials through constituency contact - Correct Answer indirectly Grassroots mobilization tries to influence whom? - Correct Answer the voters, and the community/public in general What is an example of grassroots mobilization? - Correct Answer the public campaign to expand Medicaid Electoral influence can be considered the __________________________ of policymaking. Why? - Correct Answer primary prevention. Because it is an important activity that precedes policy work. Electoral influence determines what? - Correct Answer who is elected to shape future policies For a successful electoral campaign what is needed (3)? Which ones can interest groups provide? - Correct Answer - time - money - people ?Time and people can be provided by interest groups? Who provides the money for electoral campaigns? - Correct Answer PAC's (political action committee) provide the collective financial support What does shaping public opinion involve? (2) - Correct Answer - issue advocacy - public persuasion What is an example of shaping public opinion? - Correct Answer Trump going to rallies in order to get the public to vote for republican candidates (someone of authority is trying to shape the people's opinions and trying to advocate for specific issues) What is the purpose of shaping public opinion? - Correct Answer the impression of societal consensus could, in turn, persuade policymakers as they create policy How can shaping public opinion be done for free? - Correct Answer free media in the form of news coverage How can litigation be used? - Correct Answer to shape governance toward the goals of the group (goal= end discrimination) What is an example of litigation that influences/sets precedence? - Correct Answer Roe v. Wade Brown v. Board of Education Topeka, Kansas (which was championed by NAACP) What strategies would enhance the effective influence of nurses as a collective special interest group in policy advocacy and electoral politics? (3) - Correct Answer - Too many groups/organization so we don't have a combined voice (divided- not united as nurses) - Strongly ruled in evidence (contribute by doing own research) - Find other interest groups that share the same interest What role does the nonpartisan stance of nursing PACs play in the broad engagement of nurses in electoral politics and policy advocacy? - Correct Answer ANA is to improve the healthcare system, the nursing PACs try to contribute money to candidates that depends on their policy (not going to support candidates that don't support ANA, because ANA does support universal healthcare "healthcare is a right") What is a coalition? - Correct Answer an alliance of individuals and organizations, sometimes referred to as an organization of organizations, that come together to address a specific problem or issue and reach a common goal Why form a coalition? - Correct Answer - they empower individual organizations to pool their resources and creativity to foster more strategic and effective action, enabling and enhancing communication and collaboration among members, increasing diversity by bringing together new and alternative voices and increasing the impact through greater numbers To build and maintain effective coalitions require what four ingredients? - Correct Answer - leadership - membership - resources - serendipity (the ability to seize the moment) What resources do coalitions need to accomplish their work? - Correct Answer - money/donations - website - social media Effective coalitions operate using ___________________. What does this mean? - Correct Answer group process, meaning that they go through a life cycle that involves norming and storming (creating group behavioral norms and settling disagreements) before establishing group processes What are associations? - Correct Answer groups of people who have joined together to pursue a common purpose or goal What are the common purposes and goals for RNs? - Correct Answer CARE Clinical practice Advocacy Research Education The work of professional nursing associations has the potential to benefit all nurses without regard to their ___________ in those organizations. - Correct Answer membership What are some of the challenges associations face? (3) - Correct Answer - membership (and member retention) - advocacy - leadership It is easy to see how diluted the nursing profession's voice can be because of what? - Correct Answer - So many organizations competing for membership. - the many levels of education available (an associate's, bachelor's, master's, doctor, PhD) - many nursing license classification What are some of the common reasons people do not join professional organization? - Correct Answer - time - value expectations - technology - generational difference Why is advocacy a challenge that associations face? (3) - Correct Answer - it is time-consuming, - expensive - resource-intensive Why is leadership a challenge that associations face? (3) - Correct Answer - succession planning (the identification, development and engagement of future leaders) - recycling of leaders due to lack of candidates What are the IOM recommendations? (4) - Correct Answer • Nurses should practice to the full extent of their education and training. • Nurses should achieve higher levels of education and training through an improved education system. • Nurses should be full partners, with physicians and other health professionals, in redesigning health care in the United States. • Effective workforce planning and policymaking require better data collection and an improved information infrastructure. What are some benefits of organizational involvement? (3) - Correct Answer • Information and knowledge collection and dissemination • Personal and professional development • Chapter benefits (local, regional, and special interest networking and project participation) Membership in an organization that promotes interdisciplinary and interorganizational collaboration offers special opportunities to shape _____________ - Correct Answer policy. What does the ANA say the social contract between society and nursing is? - Correct Answer - Relationship between patient and nurse - Nursing core values & ethics - Public policy & health care delivery system influence health and well-being - Individual responsibility & interprofessional involvement Collaboration among the ANA, its affiliates, and specialty nursing associations is a way for nursing to do what? - Correct Answer speak with one voice with sufficient volume to achieve greater influence in health policy. What is informatics? - Correct Answer it is the science that encompasses information science and computer science to study the process, management, and retrieval of information What is technology? - Correct Answer describes the knowledge and use of tools, machines, materials, and processes to help solve human problems. HIT encompasses a wide range of electronic tools that can help nurses to do what? (3) - Correct Answer - to access up-to-date evidence-based clinical guidelines and decision support - provide proactive health maintenance for patients - facilitates better coordination of patient care with other providers through the secure and private sharing of clinical information. What are some concerns with health information technology? - Correct Answer - privacy of personal health information in electronic form - financial, technical and social barriers to the implementation of HIT that may limit the benefits for improving care, access and efficiency What are some public policies that support HIT? - Correct Answer 1. HIPAA (Health insurance portability and accountability act) 2. Title XII aka HITECH Act What does Title XII or the health information technology for economic and clinical health act? - Correct Answer The Act promotes the use of HIT to improve health care quality, safety, and efficiency (Subtitle A Part 1) by setting the "meaningful use" of interoperable electronic health record (EHR) adoption as a critical national goal and by financially incentivizing the meaningful use, not the adoption alone, of EHRs. The Act defined privacy and security provisions to protect electronic health information. Also, the HITECH Act funded programs to support the training and consulting needs of the many health care providers seeking to adopt EHRs by offering education, outreach, and technical assistance. How is the meaningful use of EHR defined by the HITECH Act? - Correct Answer e-prescribing, engaging in health information exchange, and submission of information regarding quality measures. What is the overall goal of meaningful use of EHR? - Correct Answer The goal is to change provider behavior by increasing the use and reporting of outcome measures and increasing the exchange of electronic patient information. (streamline the process) What are the intended benefits of meaningful use of electronic records? (3) - Correct Answer 1. complete and accurate information 2. increased access 3. patient empowerment What are the five major policy initiatives (for EHR)? - Correct Answer 1. improve safety, quality and efficiency, reduce health disparities 2. involves patients and families 3. improve care coordination 4. improve population and public health 5. ensure privacy and security What were some unintended consequences of HIT? (2) - Correct Answer silent errors: those occurring during the process of entering and retrieving information and those in the communication and coordination process that the HIT is supposed to support. The implementation of HIT and information systems results in changes to what? (3) - Correct Answer - clinical practice - workflows - triggers emotions What are examples of emotions that were triggered with the implementation of HIT caused? (3) - Correct Answer stress, uncertainty resentment How does HIPPA, HITECH, and the ACA affect nursing? - Correct Answer - affect the information handling practices of all clinicians (standards for transmission) - it will foster continuity and coordination of care through detailed clinical documentation and accurate communications - The incentives for EHRs will increase the use of HIT and require all nurses to have knowledge and understanding of electronic information management. - Skill in the effective use of EHRs is also required and affects how we prepare nurses in the academic and practice settings for such systems. How is HIT applicable to nurses? (how do we translate research into practice0? - Correct Answer - nurses are knowledgeable workers (critical thinking) - nurses analyze data (looking for patterns) - nurses are able to aggregate date - nurses make decisions based on data