Identify a problem or concern in your organization, local community, or state. Examples of problems relevant
Benchmark – Creating Change Through Advocacy
The purpose of this assignment is to identify a problem or concern in your organization, local community, or state in which change can occur through advocacy and legislation.
Nurses often become motivated to change aspects within the larger health care system based on their real-world experience. As such, many nurses take on an advocacy role to influence a change in regulations, policies, and laws that govern the larger health care system.
Identify a problem or concern in your organization, local community, or state. Examples of problems relevant to nursing include, but are not limited to, title “nurse” protection, sharps injury prevention, nursing shortage, nurse well-being, valuation of nursing services, etc. Research the issue you selected and use the attached “Creating Change Through Advocacy” template to complete this assignment.
You are required to cite a minimum of three sources to complete this assignment. Sources must be published within the last 5 years, appropriate for the assignment criteria, and relevant to nursing practice.
While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.
Benchmark Information
This benchmark assignment assesses the following programmatic competencies and professional standards:
RN-BSN
9.4: Comply with relevant laws, policies, and regulations.
American Association of Colleges of Nursing Core Competencies for Professional Nursing Education
This assignment aligns to AACN Core Competencies 3.2, 3.4, 3.5, 4.3, 9.4.
Sample Expert Answer
Creating Change Through Advocacy
Name:
| Problem
In no more than 250 words, describe the problem, who is affected, and the current ramifications. Explain the consequences if the issue continues. |
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| One of the challenges that is currently facing the US healthcare system is nurse shortage. Research has shown a positive link between adequate nurse-to-patient ratios with positive health outcomes (Haegdorens et al., 2019). However, there are currently no federal mandates that require healthcare organizations to institute a recommended nurse-to-patient ratio.
This leaves the matter squarely at the hands of the healthcare facilities where most of them use their budget to dictate the number of nurses to be employed instead of the number of patients being served and the required ratios to deliver effective care. Nurse shortage at the facility level is an issue that translates to poor outcomes for the patient and the nurse. Some consequences include delivery of low-quality care, increased cases of malpractice, increased wait times, which leads to higher mortality rates, especially for patients requiring emergency care, increased cases of nurse burnout, and low job and patient satisfaction (Lasater et al., 2021). |
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| Idea for Addressing Solution
In no more than 250 words, outline your idea for addressing the issue and explain why legislation is the best course for advocacy. |
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| To help deal with the issue of nurse shortage in healthcare settings, there should be a federal mandate that requires all hospitals to implement a recommended ratio that will ensure patients receive safe and quality care. The recommended nurse-to-patient ratio for general hospitals is put at 1:5 and 1:4 for teaching hospitals (Sharma & Rani, 2020). These ratios vary depending on the settings and the patient needs, for example, in ICU settings, having a lower nurse-to-patient ratio is recommended.
Legislation is the best route for action to ensure that the recommended ratios are implemented across the board and not left at the discretion of the facility. Legislation will guarantee that patients receive the required quality of care, which will ultimately translate to different positive outcomes including lower cost of care and reduced disparities, especially in underserved communities. |
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| Research the Issue
Perform research and compile information for your idea. Present substantive evidence-based findings that support your idea for addressing the problem (research studies, reports, etc.). Include any similar legislation introduced or passed in other states. |
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| Evidence 1: In a study by Haegdorens et al. (2019) it was identified that insufficient staffing leads to rationing of time to care for each patient. This often leads to missed care events which can have disastrous outcomes including preventable deaths. | ||
| Evidence 2: McHugh et al. (2021) conducted a study on nurse-to-patient ratio legislation in Queensland Australia, in 27 intervention hospitals. The results indicated positive outcomes including lower costs from fewer readmissions and shorter lengths of stay for patients which initially contributed to more than twice the cost of the additional nurse staffing. | ||
| Evidence 3: In a study by Lasater et al. (2021) conducted in New York Hospitals, it was established that hospitals that had implemented a nurse-to-patient ratio legislation capped at 1:4 nurses to patients had better outcomes with an estimated 4370 lives saved and over $700 million in cost savings over the 2-year study period attributed to shorter lengths of stay and avoided readmissions. | ||
| Stakeholder Support
Discuss the stakeholders who would support the proposed idea and explain why they would be in support. |
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| Stakeholder(s) Supporting 1 | Nurses are the main stakeholders who will support the initiative, given that they are most affected by inadequate nurse-to-patient ratios other than patients. Nurses face high levels of burnout in settings that have inadequate ratios (Lasater et al., 2021). That’s why they will gladly accept the proposal to increase the staffing levels through a legislative mandate. | |
| Stakeholder(s) Supporting 2 | Patients will also support the legislative action because of the benefits they will enjoy from increased nurse-to-patient ratios, including shorter hospitalization periods, reduced missed care incidents, shorter delays while receiving care, and overall improved care quality (Haegdorens et al., 2019). | |
| Stakeholder Opposition
Discuss the stakeholders who would oppose the proposed idea. Explain why they would be in opposition and how you would prepare to debate or converse about these considerations. |
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| Stakeholder(s) Opposed 1 | Healthcare facility administrators will likely oppose given the implications of increased staffing on facility costs. However, after sharing evidence to show the cost savings that result from increased nurse-to-patient ratios, they may agree to support the legislative agenda. | |
| Stakeholder(s) Opposed 2 | Hospital associations will likewise oppose the legislation given the cost implications of adding more nursing staff. Hospital associations will need to be convinced that adding more nursing staff results in better patient outcomes and reduced cost of care to support the initiative. | |
| Financial Incentives/Costs
In no more than 250 words, summarize the financial impact of the issue and the idea (added costs, cost savings, increased revenue, etc.). Provide support (may include references from the “Research Your Issue” section). |
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| Using the findings from McHugh et al. (2021) and Lasater et al. (2021), implementing a legislative mandate to have adequate nurse-to-patient ratios has significant cost savings resulting from shorter lengths of stay and reduced readmission rates. Lasater et al. (2021), estimate these savings to be over $700 million, while McHugh et al. (2021) estimate the savings to be close to twice the amount of money spent in employing the additional nursing staff. Additional benefits in costs could be higher reimbursement rates resulting from the provision of quality care and reduced readmission rates, all as a result of a value-based payment model. | ||
| Legislature: Information Needed and Process for Proposal
Discuss how to advocate for your proposal using legislation. Include the following: |
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| Provide the name and complete contact information for the legislator. | Hakeem Jeffries
55 Hanson Place Suite 603 Brooklyn, NY 11217 Phone: (718) 237-2211 |
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| Describe the steps needed to present this to your legislator. | The best way to introduce the legislative agenda to the legislator is by scheduling a one-on-one meeting, first by reaching out through email and directly contacting the office for an appointment. A one-on-one meeting is preferred since there will be enough time and opportunities for the legislator to seek clarification and gain an understanding of the pertinent issue. | |
| Interprofessional Collaboration in the Legislative Arena
In no more than 250 words, discuss the role interprofessional collaboration plays in advocacy through legislation. |
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| Interprofessional collaborations play a significant role in enforcing advocacy initiatives and mobilizing the required level of support to ensure that the push for legislative action is successful. Legislation often requires garnering support from different stakeholders to highlight the importance of the issue.
In this case, interprofessional collaboration with other stakeholders in the healthcare industry will be crucial in relaying to the legislators the importance of having the required nurse-to-patient ratios and how it relates to better population health outcomes and savings in terms of government expenditure on health. Interprofessional collaboration is essential in collecting required data to support the legislative agenda and lobbying different stakeholders to support the legislative initiative (Nsiah et al.,2019). |
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| Leadership Competencies and Styles
The American Organization of Nurse Executives (AONE) has identified leadership competencies relevant for nurse leaders to guide practice within the health care system. Describe two leadership competencies identified by the AONE that would also be necessary for a nurse to advocate for the legislative solution you have proposed. Discuss how the theory of servant leadership supports these competencies. This section should be addressed in no more than 250 words. |
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| Two competencies identified by the AONE relevant for advocacy through legislation are communication and relationship management and knowledge of the healthcare environment (American Organization of Nurse Executives, 2015). Nurse leaders need to be effective in communicating with the different stakeholders, and building effective relationships that will help gain the required support for their initiative. Nurses also need to understand the dynamics of the different care delivery models to be convincing, using evidence to support their initiatives.
The theory of servant leadership requires a leader to clarify and understand what others are thinking. It requires the leader to be effective in forging useful relationships with others to achieve common goals, which aligns with the AONE competency on communication and relationship building. Additionally, the theory of servant leadership requires leaders to show high levels of competence to bring the same understanding to others. Servant leaders usually convince others by displaying high levels of competence in their leadership. |
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| Christian Principles and Nursing Advocacy
In no more than 250 words, discuss how principles of a Christian worldview lend support to legislative advocacy in health care without bias. Be specific as to how these principles help advocate for inclusiveness and positive health outcomes for all populations, including those more vulnerable, without regard to gender, sexual orientation, culture, race, religion/belief, etc. |
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| The Christian worldview considers the principle of equity and fairness as a fundamental aspect that governs society. This comes from Mathew 7:12 which teaches us to do to others what we want to be done to us. Therefore, advocacy through legislative agenda seeks to bring equity in care provision by ensuring that all patients enjoy the same level of quality care across the board.
In advocating for adequate nurse-to-patient ratios, all patients are going to enjoy quality care, with very few instances if any of missed care, thus promoting equity in care provision. The Christian worldview also advocates for the principle of love and care for others. Therefore, advocacy through legislation ensures that nurses have the required level of support, including having enough nurse workers needed to provide the best care to patients based on their needs without any limitations, whether geographical, cultural any other barriers that may limit care provision. |
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References:
American Organization of Nurse Executives. (2015). AONE Nurse executive competencies. http://www.aone.org/resources/nurse-leader-competencies.shtml
Haegdorens, F., Van Bogaert, P., De Meester, K., & Monsieurs, K. G. (2019). The impact of nurse staffing levels and nurse’s education on patient mortality in medical and surgical wards: An observational multicenter study. BMC health services research, 19(1), 864. https://doi.org/10.1186/s12913-019-4688-7
Lasater, K. B., Aiken, L. H., Sloane, D. M., French, R., Anusiewicz, C. V., Martin, B., Reneau, K., Alexander, M., & McHugh, M. D. (2021). Is hospital nurse staffing legislation in the public’s interest?: An observational study in New York state. Medical care, 59(5), 444–450. https://doi.org/10.1097/MLR.0000000000001519
McHugh, M. D., Aiken, L. H., Sloane, D. M., Windsor, C., Douglas, C., & Yates, P. (2021). Effects of nurse-to-patient ratio legislation on nurse staffing and patient mortality, readmissions, and length of stay: A prospective study in a panel of hospitals. Lancet, 397(10288), 1905–1913. https://doi.org/10.1016/S0140-6736(21)00768-6
Nsiah, C., Siakwa, M., & Ninnoni, J. P. K. (2019). Registered nurses’ description of patient advocacy in the clinical setting. Nursing Open, 6(3), 1124–1132. https://doi.org/10.1002/nop2.307
Sharma, S. K., & Rani, R. (2020). Nurse-to-patient ratio and nurse staffing norms for hospitals in India: A critical analysis of national benchmarks. Journal of Family Medicine and Primary Care, 9(6), 2631–2637. https://doi.org/10.4103/jfmpc.jfmpc_248_20
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