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Posted: October 23rd, 2023
The Role of the RN/APRN in Policy Evaluation
THE ROLE OF THE RN/APRN IN POLICY EVALUATION
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.
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
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
Select an existing healthcare program or policy evaluation or choose one of interest to you.
Review community, state, or federal policy evaluation and reflect on the criteria used to measure the effectiveness of the program or policy described.
Post an evaluation topic and a brief description of the evaluation. Discuss how social determinants impact this issue.
BY DAY 6 OF WEEK 9
Respond to at least two of your colleagues* on two different days by suggesting additional opportunities or recommendations for overcoming the challenges described by your colleagues.
The Role of the RN/APRN in Policy Evaluation
Policy evaluation is a critical component of the policymaking process that allows for the assessment of a program or policy’s effectiveness and alignment with its original goals and objectives. As frontline healthcare providers, registered nurses (RNs) and advanced practice registered nurses (APRNs) are well-positioned to evaluate existing policies and programs from the perspective of patients and communities. While direct patient care remains the top priority, considering how social determinants of health impact individuals is important for developing solutions that address medical and social needs. This paper will explore the role RNs and APRNs can play in policy evaluation through identifying gaps, recommending improvements, and strengthening efforts to mitigate the influence of social determinants on health outcomes.
When evaluating a policy or program, standard criteria include assessing impacts on health status, quality of life, healthcare costs and utilization, equity of access, patient and provider satisfaction, and unintended consequences (Ciliska et al., 2012). For example, Sommers et al. (2017) evaluated a state Medicaid expansion and found improvements in health outcomes, reductions in uncompensated care, and increased access to preventive services among low-income adults. However, the evaluation also revealed ongoing barriers for vulnerable groups experiencing homelessness, mental illness or limited English proficiency. This highlights the need for multipronged policy solutions addressing both medical and social needs.
As frontline providers, RNs and APRNs regularly interact with patients and witness firsthand how social factors influence health. In clinical practice, they are uniquely positioned to identify gaps in existing policies from the perspectives of those accessing care. For instance, in post-implementation discussions, RNs and APRNs could reflect on a policy’s impact on vulnerable patient populations and recommend strategies for improving coordination with social services, enhancing cultural sensitivity, or addressing other challenges. Input from nursing could strengthen efforts to understand and mitigate how social determinants like housing instability, lack of transportation, or low health literacy undermine policy aims.
Going forward, RNs and APRNs should feel empowered to contribute their insights on policy evaluation. In academic discussions, focusing a post on a policy or program of interest provides an opportunity to analyze observed impacts and suggest recommendations for overcoming barriers revealed through interactions with patients. Responding to peers’ posts allows for sharing strategies for coordinating medical and social efforts. In this way, nursing perspectives can enhance policy efforts to improve population health by strengthening consideration of the social factors that influence health outcomes.
Ciliska, D., Thomas, H., & Buffett, C. (2012). An introduction to evidence-informed public health and a compendium of critical appraisal tools for public health practice. National Collaborating Centre for Methods and Tools.
Hodges, B. C., & Videto, D. M. (2011). Assessment and planning in health programs (2nd ed.). Sudbury, MA: Jones and Bartlett Publishers.
Sommers, B. D., Maylone, B., Blendon, R. J., Orav, E. J., & Epstein, A. M. (2017). Three-Year Impacts Of The Affordable Care Act: Improved Medical Care And Health Among Low-Income Adults. Health Affairs, 36(6), 1119–1128. https://doi.org/10.1377/hlthaff.2017.0293