Fluent Essays

Revisions are needed on the paper I submitted for school. I have uploaded a file titled default.pdf which explains. Any section that scored less than a 3 needs to be revised. Please read teachers comments. Aspects B3, B5, C2 - C2f, D1 and D2 require addressing, completion and additional details in order to satisfy the task requirements. Please confirm this received and please let me know when I will get revisions back. Also if something is not understood please let me know. I also attached another document that was sent by my professor that provided tips on how to complete the sections. Thanks! FAQ’s – You Asked, We Answered C159: Policy, Politics, and Global Health Frequently Asked Questions about the Policy Paper Clarifying the Rubric Criteria Section A: Describing Importance of your selected issue and why it is important A1. Public Policy Issue What is the issue/problem you are trying to improve? A1a. Issue Selection Why did you select this issue to focus on? Why is it a problem for your community? Your state? Or the nation? A1b. Issue Relevance Why is this topic important to the health of the public? Why should this issue be addressed as a public policy? Be sure to use at least 2 citations from current (within the last five years), academically appropriate literature to support why this issue in an important public issue. We recommend that you include at least 2 – 3 nursing sources (from nursing journals).  Nursing research includes articles from nursing journals or research that has been conducted by nurses. Although this is not a requirement for this section, you will be required to use nursing research in B1a. A1c. Financial Impact What is impact of your policy on the system? For example, if your policy relates to nurse staffing ratios, it could cost organizations considerably more to hire additional nurses. However, with improved staffing, patient outcomes may improve and re-admissions might be avoided, so in the long run, money is saved for both the institutions and the patients. Will your policy require additional people or funding? Is there a potential for your policy to save money over the long term? A2. Personal Values In this section you will discuss how your own personal/professional values relate to this policy. Have you experienced or seen adverse effects of this issue on people’s health or on the nursing profession? Why do you personally believe that this is an important policy? It is okay to write in 1st person to discuss the personal values, why you selected the topic, and the ethical principle you think applies to the policy.     A2a. Ethical Principle, refers specifically to an ethical Principle or Theory. You can find a list of Nursing Ethical Principles and Theories in the Ethical Theories Applied to Nurses Policy Positions unit of the course of study. There is a link to a handout from the ANA which identifies and defines nursing Ethical Principles.  We suggest you pick 1 or 2 from this list and describe how the nursing ethical principle/s could apply to your proposed policy.  The ANA Ethical Theories and Principles document can also be found here: http://nursingworld.org/MainMenuCategories/EthicsStandards/Resources/Ethics-Definitions.pdf Section B: The Top-Down Approach B1. Decision Maker: You will need to identify who you will give your proposal to. Who has the power and authority to move your policy forward? For example, if you are trying to change a state law, your Decision Maker would be a state Representative or State Senator who can draft a bill. If you are trying to change a policy in all schools throughout your state, your Decision Maker might be the State Superintendent of Schools. If you are trying to change a nursing license requirement, your initial decision maker would most likely be someone at the State Board of Nursing, who would then make a recommendation to a lawmaker. In this section, be sure you list the Name and Title of Decision Maker, i.e.: Senator Joan Brown, California Senate District 3. For this section you only have to list the name and title of the Decision Maker.      In B1a. Explanation you need to use nursing research to support why this issue needs to be addressed by a public policy (law).  Why is this issue important enough that it should be a law?  What is the impact of your issue on the health of the public?  You may have already discussed this (especially in section A) but here you’ll summarize the importance and demonstrate that this topic is important enough that your decision maker should move your policy forward. We recommend that you include at least 2 – 3 nursing sources (from nursing journals), and these may have already been cited in other parts of your paper.  Nursing research includes articles from nursing journals or research that has been conducted by nurses.      In B2. Challenges. You will identify some challenges that your decision maker will likely face in trying to get the bill passed into law. Typically, challenges that lawmakers face are during public hearings (who or what groups may speak out in opposition to the bill?) and funding - if this policy will require additional funding, where will the government get the money? So, a challenge would be that there may not be appropriate funding to support the policy proposed. For purposes of this paper, you will not focus on implementing the policy, but your focus should be on the steps to getting the policy into law or formal policy statement.     B3. Options. This section asks you to describe some options the Decision Maker has when you present your policy proposal.  What choices/options does the Decision Maker have when they hear your proposal?  We usually recommend that students try to identify 3 options. The first option is often to do nothing...The decision maker has the option of reading your policy proposal and deciding to just leave things as they are currently (the status quo). Why do you think this option is not a good option for your state? A second option for the decision maker is to set a different policy. In this case, it might be that the decision maker decides to require some alternative, or part-way, measure. This might be a policy that another state has adopted, or one that you read about. Why would this second option not be the best option for your state (i.e., how might this option fall short of fully addressing the problem?). A third option might be to support and pass your policy proposal for mandated staffing ratios. Again, you would provide your rationale - Why would your Policy (the 3rd option) be the very best for your state?      In B4. Course of Action. You will be writing recommendations for addressing/reducing the Challenges you identified in section B2. What might your lawmaker do to address those challenges? For example, if one of the challenges is that the general public and other lawmakers may not understand the health risks and importance of vaccines, one Action Step the decision maker might do is to invite the State Epidemiologist to the public hearing to present information about risks of disease and benefits of immunizations.       In section B5 Success of Policy Brief. We recommend that you identify successes in both the process and long term outcome of your policy change. For example, if you are trying to get a law passed, your first success is when a legislator agrees to sponsor a bill, the next success is when the bill passes committee hearings, etc. Once the bill in signed into law, what do you expect to be different? For example, if we were proposing a change in childhood immunization requirements, a longer success would be that: Over time there would be a notable decrease in morbidity, mortality, and health care costs related to adverse events or preventable disease spread resulting from lack of immunizations. Section C: The Bottom-up Approach Section C1. This section asks you to identify an organization or community that has an interest in your topic. In reality you would probably partner with several different groups, but for this paper we recommend that you identify just one group. This section is only naming the organization you will work with. In Section C1a. Summary of Expressed Interest, you will discuss how you know that your selected organization is interested in this health issue/problem. Do they have information on their website? Printed materials? Is this issue a topic at annual meetings? Or…? What makes you think they might want to collaborate with you to address this problem? C2: CBPR Principles. In this section you’ll identify 3 CBPR Principles that you will use in your work with the community group you chose to collaborate with. You can find a list of 9 CBPR Principles in your Course of Study: Open the Policy Process unit from the left-hand menu bar, when this section opens, scroll down to the “Apply: Bottom/-up Approach” section. There you’ll find a link to Promoting Healthy Public Policy through Community-Based Participatory Research: Ten Case Studies . Pages 7 – 15 provide an overview and introduction to Community Based Participatory Research (CBPR), and a list of the 9 CBPR principles can be found at the bottom of page 13. From this list of 9 Principles, you’ll select 3 principles you could use in your work with your selected group. You can also find this document directly at: http://depts.washington.edu/ccph/pdf_files/CBPR_final.pdf A good website to go to for a bulleted list of the CBPR principles is: https://depts.washington.edu/ccph/cbpr/u1/u11.php C2a. Approach and Collaboration. How will you start your work with the selected community group? How will you initiate contact with the group? Will you call the group president? Attend a regularly scheduled meeting? Once you’ve made initial contact, how might your start actually working with group members? Will you meet once each week over lunch? Will you attend their already scheduled group meetings to present and discuss information about your topic? Try to be as specific as possible – with enough detail that someone else could follow your plan if you weren’t able to work on the policy. In C2b. Goal Alignment. You will discuss how you know that the organization’s goals are similar to the goal of your policy. For example, if you were working with a school nurses’ group to address the issue of childhood obesity, you might discuss how the School Nurses’ Association is committed to improving health for children which directly aligns with your policy goal of increasing access to health foods and physical activity in schools. In C2c Action Steps. You will want to talk about the specific steps your group will take to influence a change related to your problem/issue. You action steps (maybe 3 -5 important activities) should be specific enough that someone else could follow your plan.  For example, of you are thinking about student navigators, you might identify that your group will talk with nursing student classes at the local college. You will then evaluate these action steps in C2f.     C2d Roles/Responsibilities. This section is about the roles and responsibilities that members take in the committee work.  It helps to think about what you need the community group to do - then you can identify specific individuals to take on those functions. For example, someone will need to serve as the facilitator or convener of your meetings or someone with experience working with the media might serve as a Media Relations expert for your group. If you have planned a town hall meeting you may want to include a subject matter expert to lead the public session, or you may want someone with experience as a health educator to work with a parents group, etc. We recommend discussing 3 - 4 key roles that you will need members to assume. The important part is to identify what your group needs people to do in order to accomplish your Action Steps, and then identify group members (by position) who have the knowledge, skills, or experience to take on those roles.    C2e Key elements. In this section you are evaluating the process of how you worked with your community group. Specifically, you will want to discuss how your committee used or would use the 3 CBPR principles you identified in section C2. What did it look like as your group used or would use each of the 3 principles? C2f Evaluation. In this section you will evaluate the success of your work with the committee. We recommend that you identify how you will measure the success of each of your Action Steps (from C2c) and the CBPR principles, and also include one longer term outcome - what will be different if your committee is successful in meeting your goal? If you said you would meet bi-monthly, did you?  If you said you would develop a specific curriculum or plan within 3 months, did you Once you evaluate the Action Steps, we recommend identifying at least one longer term outcome.  What will be different a year (or 5 years) later if your policy changes are effective? Section D: Evaluating the Effectiveness of the two Approaches for changing policy D1: Strengths of Each Approach. In this section you should identify and discuss at least a couple of strengths of the Top-Down Approach (the policy approach you discussed in part B) and also identify and discuss some strengths of the Bottom-up Approach (the community-based approach you wrote about in Part C). D2: Challenges of Each Approach. In this section you will identify some challenges, or barriers, to both the Top-Down, formal policy approach you discussed in Part B as well as some challenges or barriers to the Bottom-up, community-based approach, you discussed in Part C. D3. Most Effective Approach. In about a paragraph or so you will discuss which approach (Top-Down or Bottom-Up) you would select to use if you were going to actually work on this policy change. There is not a “right” answer, because both approaches can be used effectively to change policy. Based on what you know about the issue, about your community, and about the political climate in your area, which approach do you think would work best if you wanted to make this policy change? It is okay to write this in 1st person. Evaluation Results Author: Melissa Smith Date Evaluated: 04/17/2016 03:21:34 PM (MDT) DRF template: Policy, Politics, and Global Health (GR, C159, UUT2­1014) Program: Policy, Politics, and Global Health (GR, C159, UUT2­1014) Evaluation Method: Using Rubric Evaluation Summary for Policy, Politics, and Global Health: UUT Task 1 Final Score: Does not Meet Overall comments: 4/17/16 The submission discusses the development and analysis of a public policy that advocates for improvement in the health of the public and the nursing profession globally, such as with safer nursing ratios. The submission indicates that the effects of a poor nurse­to­patient ratios result in poor care outcomes, increase in safety errors, increase in patient and nursing dissatisfaction, increase in healthcare costs as a result of high nursing turnover, medical errors and poor reimbursement rates. With adequate and safer staffing, all of the above mentioned will decrease ­ if not eradicated or circumvented.  Aspects B3, B5, C2 ­ C2f, D1 and D2 require addressing, completion and additional details in order to satisfy the task requirements. Please consult with the course mentor before working further on this task. Detailed Results (Rubric used: UUT Task 1 (1014)) Articulation of Response (clarity, organization, mechanics)   (0) 0=Unsatisfactory/Not present (1) 1=Does Not Meet Standard (2) 2=Minimally Competent (3) 3=Competent (4) 4=Highly Competent The candidate provides unsatisfactory articulation of response.   The candidate provides weak articulation of response.   The candidate provides limited articulation of response.   The candidate provides adequate articulation of response.   The candidate provides substantial articulation of response.   Criterion Score: 4.00  Comments on this criterion: 4/17/16 The submission is organized, easy to follow and without errors. A1. Public Policy Issue   (0) 0=Unsatisfactory/Not present (1) 1=Does Not Meet Standard (2) 2=Minimally Competent (3) 3=Competent (4) 4=Highly Competent The candidate does not provide a plausible analysis of a health or nursing profession public policy issue that impacts a group of people and requires a policy change.   The candidate provides a plausible analysis, with no detail, of a health or nursing profession public policy issue that impacts a group of people and requires a policy change.   The candidate provides a plausible analysis, with limited detail, of a health or nursing profession public policy issue that impacts a group of people and requires a policy change.   The candidate provides a plausible analysis, with adequate detail, of a health or nursing profession public policy issue that impacts a group of people and requires a policy change.   The candidate provides a plausible analysis, with substantial detail, of a health or nursing profession public policy issue that impacts a group of people and requires a policy change.   Criterion Score: 3.00    Printed on: 04/17/2016 05:26:23 PM (EST) https://www.taskstream.com/ Comments on this criterion: 4/17/16 The submission identifies the policy issue for change as safe nursing staffing. A1a. Issue Selection   (0) 0=Unsatisfactory/Not present (1) 1=Does Not Meet Standard (2) 2=Minimally Competent (3) 3=Competent (4) 4=Highly Competent The candidate does not provide a logical discussion of why the public policy issue was selected.   The candidate provides a logical discussion, with no detail, of why the public policy issue was selected.   The candidate provides a logical discussion, with limited detail, of why the public policy issue was selected.   The candidate provides a logical discussion, with adequate detail, of why the public policy issue was selected.   The candidate provides a logical discussion, with substantial detail, of why the public policy issue was selected.   Criterion Score: 3.00  Comments on this criterion: 4/17/16 The submission provides a detailed discussion suggesting that the policy was selected because with a high patient ratio, nurses are unable to provide proper, competent and safe care for patients, resulting in them receiving less care. A1b. Issue Relevance   (0) 0=Unsatisfactory/Not present (1) 1=Does Not Meet Standard (2) 2=Minimally Competent (3) 3=Competent (4) 4=Highly Competent The candidate does not provide a logical discussion of the relevance of this public policy issue to health or the nursing profession, using 2 pieces of academically appropriate literature from the last five years.   The candidate provides a logical discussion, with no support, of the relevance of this public policy issue to health or the nursing profession, using 2 pieces of academically appropriate literature from the last five years.   The candidate provides a logical discussion, with limited support, of the relevance of this public policy issue to health or the nursing profession, using 2 pieces of academically appropriate literature from the last five years.   The candidate provides a logical discussion, with adequate support, of the relevance of this public policy issue to health or the nursing profession, using 2 pieces of academically appropriate literature from the last five years.   The candidate provides a logical discussion, with substantial support, of the relevance of this public policy issue to health or the nursing profession, using 2 pieces of academically appropriate literature from the last five years.   Criterion Score: 3.00  Comments on this criterion: 4/17/16 The submission provides a practical discussion regarding the relevance of the issue, such as how implementation of a safer staff nursing policy facilitates positive nursing and patient outcomes through competent, efficient, safe and adequate care. A long term benefit equates to increased patient and nursing satisfaction, a decrease in staff turnover and an increase in reimbursements for the healthcare institution. A1c. Financial Impact   (0) 0=Unsatisfactory/Not present (1) 1=Does Not Meet Standard (2) 2=Minimally Competent (3) 3=Competent (4) 4=Highly Competent The candidate does not provide an accurate description of the financial impact of the public policy on an organization or on a community.   The candidate provides an accurate description, with no detail, of the financial impact of the public policy on an organization or on a community.   The candidate provides an accurate description, with limited detail, of the financial impact of the public policy on an organization or on a community.   The candidate provides an accurate description, with adequate detail, of the financial impact of the public policy on an organization or on a community.   The candidate provides an accurate description, with substantial detail, of the financial impact of the public policy on an organization or on a community.   Criterion Score: 3.00  Comments on this criterion: 4/17/16 The submission provides a practical discussion regarding the financial impact of the policy, including improving the number of nurses in healthcare facilities will also increase the labor costs because of overtime pay, increasing number of employees, skill mix increase and increasing the market wages for nurses and other healthcare personnel. A2. Personal Values   (0) 0=Unsatisfactory/Not (1) 1=Does Not Meet Standard (2) 2=Minimally Competent (3) 3=Competent (4) 4=Highly Competent   Printed on: 04/17/2016 05:26:23 PM (EST) https://www.taskstream.com/ present The candidate does not provide a plausible analysis of how the candidate’s values impact the candidate’s position on the public policy issue.   The candidate provides a plausible analysis, with no detail, of how the candidate’s values impact the candidate’s position on the public policy issue.   The candidate provides a plausible analysis, with limited detail, of how the candidate’s values impact the candidate’s position on the public policy issue.   The candidate provides a plausible analysis, with adequate detail, of how the candidate’s values impact the candidate’s position on the public policy issue.   The candidate provides a plausible analysis, with substantial detail, of how the candidate’s values impact the candidate’s position on the public policy issue.   Criterion Score: 3.00  Comments on this criterion: 4/17/16 A discussion supporting the policy, indicating that safe staff nursing helps in the improvement of quality care, is located. A2a. Ethical Principle or Theory   (0) 0=Unsatisfactory/Not present (1) 1=Does Not Meet Standard (2) 2=Minimally Competent (3) 3=Competent (4) 4=Highly Competent The candidate does not provide a logical discussion of the ethical principle or theory that underpins the candidate’s perspective.   The candidate provides a logical discussion, with no detail, of the ethical principle or theory that underpins the candidate’s perspective.   The candidate provides a logical discussion, with limited detail, of the ethical principle or theory that underpins the candidate’s perspective.   The candidate provides a logical discussion, with adequate detail, of the ethical principle or theory that underpins the candidate’s perspective.   The candidate provides a logical discussion, with substantial detail, of the ethical principle or theory that underpins the candidate’s perspective.   Criterion Score: 3.00  Comments on this criterion: 4/17/16 The submission provides a discussion identifying the ethical principle theory underpinning the perspective as nonmaleficence. B1. Decision Maker   (0) 0=Unsatisfactory/Not present (1) 1=Does Not Meet Standard (2) 2=Minimally Competent (3) 3=Competent (4) 4=Highly Competent The candidate does not identify the appropriate decision maker (name and title) who will receive the policy brief.   Not applicable.   Not applicable.   Not applicable.   The candidate identifies the appropriate decision maker (name and title) who will receive the policy brief.   Criterion Score: 4.00  Comments on this criterion: 4/17/16 The submission identifies the decision maker as the healthcare human resources manager Dr. Donald Trumpet. B1a. Explanation   (0) 0=Unsatisfactory/Not present (1) 1=Does Not Meet Standard (2) 2=Minimally Competent (3) 3=Competent (4) 4=Highly Competent The candidate does not provide a logical explanation of why the public policy requires the decision maker’s attention, using relevant nursing research from the last five years to support the position.   The candidate provides a logical explanation, with no detail, of why the public policy requires the decision maker’s attention, using no relevant nursing research from the last five years to support the position.   The candidate provides a logical explanation, with limited detail, of why the public policy requires the decision maker’s attention, using limited relevant nursing research from the last five years to support the position.   The candidate provides a logical explanation, with adequate detail, of why the public policy requires the decision maker’s attention, using adequate relevant nursing research from the last five years to support the position.   The candidate provides a logical explanation, with substantial detail, of why the public policy requires the decision maker’s attention, using substantial relevant nursing research from the last five years to support the position.   Criterion Score: 3.00    Printed on: 04/17/2016 05:26:23 PM (EST) https://www.taskstream.com/ B2. Challenges   (0) 0=Unsatisfactory/Not present (1) 1=Does Not Meet Standard (2) 2=Minimally Competent (3) 3=Competent (4) 4=Highly Competent The candidate does not provide a logical discussion of the main challenges of addressing the selected public policy issue.   The candidate provides a logical discussion, with no detail, of the main challenges of addressing the selected public policy issue.   The candidate provides a logical discussion, with limited detail, of the main challenges of addressing the selected public policy issue.   The candidate provides a logical discussion, with adequate detail, of the main challenges of addressing the selected public policy issue.   The candidate provides a logical discussion, with substantial detail, of the main challenges of addressing the selected public policy issue.   Criterion Score: 3.00  Comments on this criterion: 4/17/16 The submission provides a reasonable discussion regarding the challenges of addressing the issue, including ineffective communication and collaboration of nursing needs and lack of professional organization support. B3. Options/Interventions   (0) 0=Unsatisfactory/Not present (1) 1=Does Not Meet Standard (2) 2=Minimally Competent (3) 3=Competent (4) 4=Highly Competent The candidate does not provide a logical discussion of the primary options and/or interventions for the decision maker, including why they are tangible.   The candidate provides a logical discussion, with no detail, of the primary options and/or interventions for the decision maker, including why they are tangible.   The candidate provides a logical discussion, with limited detail, of the primary options and/or interventions for the decision maker, including why they are tangible.   The candidate provides a logical discussion, with adequate detail, of the primary options and/or interventions for the decision maker, including why they are tangible.   The candidate provides a logical discussion, with substantial detail, of the primary options and/or interventions for the decision maker, including why they are tangible.   Criterion Score: 1.00  Comments on this criterion: 4/17/16 The submission provides a discussion regarding simple ways of intervening in safe nurse staffing decision­making process; however an adequate discussion of the primary options or interventions for Dr. Trumpet and why they are tangible is not located. B4. Course of Action   (0) 0=Unsatisfactory/Not present (1) 1=Does Not Meet Standard (2) 2=Minimally Competent (3) 3=Competent (4) 4=Highly Competent The candidate does not provide an appropriate proposal for a persuasive course of action for the decision maker, including ways to avoid the challenges identified in part B2.   The candidate provides an appropriate proposal, with no support, for a persuasive course of action for the decision maker, including ways to avoid the challenges identified in part B2.   The candidate provides an appropriate proposal, with limited support, for a persuasive course of action for the decision maker, including ways to avoid the challenges identified in part B2.   The candidate provides an appropriate proposal, with adequate support, for a persuasive course of action for the decision maker, including ways to avoid the challenges identified in part B2.   The candidate provides an appropriate proposal, with substantial support, for a persuasive course of action for the decision maker, including ways to avoid the challenges identified in part B2.   Criterion Score: 3.00  B5. Success of Policy Brief   (0) 0=Unsatisfactory/Not present (1) 1=Does Not Meet Standard (2) 2=Minimally Competent (3) 3=Competent (4) 4=Highly Competent The candidate does not provide a logical discussion of how the candidate will evaluate the success of the The candidate provides a logical discussion, with no detail, of how the candidate will evaluate the success of The candidate provides a logical discussion, with limited detail, of how the candidate will evaluate the success of The candidate provides a logical discussion, with adequate detail, of how the candidate will evaluate the success of The candidate provides a logical discussion, with substantial detail, of how the candidate will evaluate the   Printed on: 04/17/2016 05:26:23 PM (EST) https://www.taskstream.com/ the success of the policy brief (a top­down approach).   evaluate the success of the policy brief (a top­ down approach).   evaluate the success of the policy brief (a top­ down approach).   evaluate the success of the policy brief (a top­ down approach).   will evaluate the success of the policy brief (a top­down approach).   Criterion Score: 0.00  Comments on this criterion: 4/17/16 A clear discussion regarding how to evaluate the success of the policy brief is not located. C1. Identified Organization or Community   (0) 0=Unsatisfactory/Not present (1) 1=Does Not Meet Standard (2) 2=Minimally Competent (3) 3=Competent (4) 4=Highly Competent The candidate does not identify an organization or community that has expressed interest in the selected health or nursing profession public policy issue.   Not applicable.   Not applicable.   Not applicable.   The candidate identifies an organization or community that has expressed interest in the selected health or nursing profession public policy issue.   Criterion Score: 4.00  Comments on this criterion: 4/17/16 The submission identifies the International Council of Nurses (ICN) as the organization with interest in the policy issue. C1a. Summary of Expressed Interest   (0) 0=Unsatisfactory/Not present (1) 1=Does Not Meet Standard (2) 2=Minimally Competent (3) 3=Competent (4) 4=Highly Competent The candidate does not provide a logical summary of evidence supporting why the organization or community has expressed interest in the selected public policy issue.   The candidate provides a logical summary, with no detail, of evidence supporting why the organization or community has expressed interest in the selected public policy issue.   The candidate provides a logical summary, with limited detail, of evidence supporting why the organization or community has expressed interest in the selected public policy issue.   The candidate provides a logical summary, with adequate detail, of evidence supporting why the organization or community has expressed interest in the selected public policy issue.   The candidate provides a logical summary, with substantial detail, of evidence supporting why the organization or community has expressed interest in the selected public policy issue.   Criterion Score: 3.00  C2. CBPR Principles   (0) 0=Unsatisfactory/Not present (1) 1=Does Not Meet Standard (2) 2=Minimally Competent (3) 3=Competent (4) 4=Highly Competent The candidate does not identify 3 CBPR principles the candidate could use to work with the organization or community to address a policy change for the public policy issue.   Not applicable.   The candidate accurately identifies 1­2 CBPR principles the candidate could use to work with the organization or community to address a policy change for the public policy issue.   Not applicable.   The candidate accurately identifies 3 CBPR principles the candidate could use to work with the organization or community to address a policy change for the public policy issue.   … Running head: HEALTH, POLICY AND POLITICS TRENDS 1 HEALTH, POLICY AND POLITICS TRENDS 17 Health, Policy and Politics trends Name: Institutional affiliations Health, Policy, and Politics Trends Reflective Essay on the Ethics and the Public Policy Issue Analysis of the public health problem that requires policy change The modern health care system is in trouble, and it needs change. Additionally, the experiences of many nurse practitioners in the modern healthcare world are playing a very crucial role in motivating them to undertake some form of advocacy to influence policy changes, laws, or regulations that rule the larger health care system (Hofrichter et al., 2010). I believe that this type of advocacy requires stepping beyond our practice setting into the world most of us are less familiar with. In simple terms, this unfamiliar world revolves around politics, policies and basically, the world in which most nurse practitioners do not feel comfortable to operate efficiently. Moreover, the location of decision making in both private and public sector, and the nature of the health care policy, both have an implication on the characteristics and attributes of any healthcare system (Hofrichter et al., 2010). Furthermore, with the few years I have experienced as a nurse practitioner, I have come to realize that, most of the healthcare policies are influenced and impacted by the preferences of leaders in politics. Relevance of the Public Policy Issue Of Health and the Nursing Profession The current healthcare environment is filled with a myriad of healthcare policies, regulations, and laws imposed by private sectors, government agencies, and insurance institutions as well. In this case, these multiple strategies challenge both patients and nurses who are in most cases caught between the constraints revolving around costs as well as accessibility to efficient and quality health care. For instance, the United States Census Bureau that was collected in the year 2005 reported that the number of insured people has grown to 46.6 million while the health care cost continues to rise (Hofrichter et al., 2010). Another notable example is the report compiled by the Commonwealth Fund which acknowledges that a high-quality health care is in most cases delivered by a system of government that is poorly coordinated thus driving up costs while at the same time putting patients at risk. Therefore, because the modern world is characterized by rising costs, variable quality, and deteriorating costs, I believe improving the legislative health care policy performance is an issue that requires national urgency (Hofrichter et al., 2010). According to me, these reports are not surprising. As I interact with patient families and patients, as a nurse, I am always the first provider to have a clear view of when and how the system of healthcare is insufficiently meeting the needs of its patients. In this case also, we are always positioned every day, to see not only the effect of the health care policies for individual patients but also the much-needed change when it comes to healthcare delivery. In this circumstances, it is not only the patients and their families that suffer but the community as well. Financial Impact of the Policy On Health on the Community One notable example in which the community is involved in addressing inadequate healthcare delivery is through the cost of prescription drugs. In this case, I believe so many healthcare providers can bear witness and share how so many patients have requested them to limit or reduce the frequency in which their prescriptions are awarded. Because they have inadequate funds or in other words, they simply lack information and knowledge on how to get discounts or community resources to enable them to fill their discounts. The leaders in politics should be able to formulate policies that offer training and education to patients in matters revolving around health are a system so as to increase their awareness when it comes to prescription and the economic resources available. Owing to the global legislative health care policy, I believe nurses are in a better position to provide the much-needed information about the healthcare practices. As a member of the nursing community, I think each and every member of the society has an opportunity and the responsibility to offer accurate and up-to-date information. Additionally, any nurse practitioner who has a passing interest in influencing the policy process even if they possess limited resources and time can always find a way to establish themselves as confident advocates. In other words, it is up to a nurse as an individual to decide on potential strategies they think will be efficient and they feel comfortable using given their time and energy. Ethical Principles Impact My Position on the Policy Issue The Principle of Nonmaleficence which requires nurses to do no harm is one reason I advocate for the improvement of legislative policies. In other words, the primary fundamental objective of most nurse practitioners is to protect the safety of their patients by increasing the quality of care and facilitating their access to the needed resources as well as promoting quality health care. In this case, health care systems are developing and changing rapidly. Therefore, leaders in politics and nurses should practice the principle of autonomy to perfume their activities with self-determination when evolving with these changes. As a result, nurses also needs to employ the principle of beneficence to influence the formulation policy revolving around health care systems postulated by local politicians rather than just helping in the implementation process. In so doing, the quality of healthcare both locally and globally will improve tremendously regarding service delivery, prescription cost, and patient knowledge of healthcare resources and medicine. Policy Brief for the Policy Issue Identification of the Decision Maker Political and professional courage is needed amongst nurse practitioners and professional nursing organization’s managers to steer nursing towards curbing the dualisms of individuals versus the acknowledged collective health, as well as, medical versus social health model. Additionally, having a vision of an activist, informed nursing profession, can play a primary part in improving the level of the nursing discourse in the community. In this case, according to the legislative policy, activism can offer to mean to a nursing inquiry such that the work of nurses must interconnect with the work of the larger community. The local political leaders and healthcare managers need to provide the suitable conditions for Nurse Practioner to possess the responsibility and right to act as political elements in both national and political arenas. Moreover, the nurses as activists need to formulate an approach that makes them resourceful to policy makers and community members. In other words, for this policy advocacy to be successful, nurses as interpreters of science and advocates, must feel free and empowered to raise their voice in support of a healthcare policy. In this case, the legislative healthcare policy requires the attention of the local political leader who in this case, is Honorable Donald Trumpet because it is only through him that the nurses will feel empowered to influence the legislative policy decisions. Reasons Why the Legislative Policy Requires the Attention of the Political Leader Previous research indicates that Honorable Donald Trumpet and nurse practitioners participating in the legislative policy advocacy process will need to deliberate on their very own professional goals revolving around the particular societies within their working jurisdiction. Additionally, this goal may encompass challenging healthcare delivery, proposing different methodologies for research, challenging social policy, and regulating and promoting the democratization of the institutions which in one way or the other determine research policy and priorities. Moreover, the legislative policy will require the attention of the political leader because; it will motivate nurse practitioners to venture and step out into the modern and unfamiliar politics world. In this case, being politically active does not necessarily mean that they take the initiative, but it needs a network that can advise nurses when they need political leadership and response at the appropriate time. However, having a legislative sponsor or leader for a piece of legislation policy does not necessarily ensure that the implication of the policy will be smooth. In most cases, on significant but controversial elements, it is universally acknowledged that there are equal numbers of individuals who are trying to mobilize their forces to oppose the policy or the element at hand. Therefore, the political leader of the individuals who will receive the policy from the nurse Practioner should be able to make the nurse practitioners to understand that the legislation process requires adequate negotiation and consensus. A study conducted by Institute of Medicine that revolved around the “Future of Nursing; Leading Change, Advancing health”, released in the year 2010. It is acknowledged that political leaders should review the legislative health care policies to transform the nursing profession to enhance the value and quality of healthcare services in America (Israel, 2013).. As a political leader, research indicates that Honorable Donald Trumpet should be able to campaign and advocate for laws and regulations that are meant to improve the quality of the healthcare services. Challenges Involved In Addressing the Health Care Policy Issue In spite of the ongoing severe nursing shortage, the aging nursing workforce, wide-spread dissatisfaction among some bedside nurses, nurse conflicts with physicians coupled with the lack of opportunities to successfully diversify the nursing profession demographically, the nursing profession is believed to have not actualized their collective power. In other words, realizing the objective of the legislative health care policy may be more challenging because; nursing has not grown into a powerful, cohesive professional force that could act as a counterweight to the medicine in the global policy arena (Israel, 2013). Additional when it comes to matters of advocacy, it is acknowledged that not so many nurses can collaborate with political leaders in issues revolving around other health professional policies. Another challenging aspect when it comes to this policy is the fact that both nurses and the local political leaders are very busy people. In other words, nurses are occupied by health care homes, families, children or elderly care homes hence time for political connection is very limited and rare. Some factors restrain the potential power of Nurse Practioner to collectively and individually to influence the decisions of the politicians in matters revolving around legislative health care policy. First, failure to convey a very clear message that may encourage a larger number of Nurse Practioner to exercise their valuable right when it comes to choosing of leaders. Second, there is inadequate nurse membership in professional organizations that advocate collectively for health care policy matters. Finally, lack of primary education in issues revolving around health advocacy issues that can play a very crucial role in influencing the political arena. Primary Options and Interventions for the Decision Maker Any political leader and a Nurse Practioner who has an interest in influencing the policy making the process even if they possess very limited resources and time can quickly establish a way of becoming a confident advocate. Additionally, there are quite some very simple ways of intervening in the legislative policy decision-making process. One is writing a very official but simple letter to the ministry of health. Second is making a telephone call and finally, being elected or nominated for a political office. Once the policy maker is aware of the situation in which a legislative policy will improve the delivery system of the healthcare environment, one can move to explore the advantages and disadvantages of possible solutions and afterward, work to get others to get involved and interested in the social advocacy issue. Moreover, depending on the policy maker’s level of confidence, they may also campaign and testify about the problem or work with media channels in bringing attention to the advantages of the healthcare policy decision. Persuasive call of action for the decision maker Many policies making issues may be too complex to be easily resolved by just making phone calls or even be solved by the dedicated efforts of an individual. Additionally, in reality, there are very few policy changes that have occurred without collective efforts of many social policy change advocates. Therefore, to solve the challenges associated with this policy change, to join a professional nursing advocacy organization is a very crucial way to enhance the policy maker’s individual advocacy efforts. Moreover, nursing professional associations possess more resources and are in a better position to effectively strategize to bring the perspectives to legislative decision policymakers than those nurses acting individually. In other words, the professional nursing organizations are better placed to monitor public policy and in the process, provide ways for its members to learn and know more about health decision makers. Furthermore, the challenges revolving around the nursing political affiliation can be easily solved by professional nursing organizations because they provide tools and information to ensure that those political candidates who are supportive of legislative health care are re-elected into office. Another common persuasive mode will revolve around how active the advocate can practice and demonstrate effective communication skills so as to convince others to listen and benefit from the perception of others. In such cases, repeated and constant communication with legislators as well as their staff members in a very straightforward manner would significantly increase the likelihood that the legislative health care policy and information postulated by an individual would be able to be understood and heard. How to Evaluate the Success of the Policy Brief Governance institutions play a vital role in developing policy implementation strategies needed to manage risks as well as build adaptive capacity starting from the national level to household level or the project that concerns the decision makers and the people. The legislative health care policy will clearly be a success if it is showcasing consistent and clear goals that are articulated by the top government officials or the political leader (Israel, 2013). Additionally, the implementation process of the policy would be advantageous if the nurses involved are showing clear knowledge and understanding of the pertinent consequences of the policy regarding causes and effects of the potential solutions to the ongoing problem. Moreover, the legislative policy should also have a clear hierarchy of authority with most of the policy decision established at the top leadership level, and the system itself is aligned with the existing rules. In other words, the top-down approach is the rational, comprehensive approach to policy planning. In this case, the legislative health care policy will only be a success if the policy is consistent with an overhead democracy such that the elected government officials delegate implementation duties and authority to those public servants who are non-elected but are accountable to those democratically appointed leaders. In this instance, it is succinct that the policy implementation process will also include the modification and evaluation stage where the already existing policies are revisited and amended according to the changing circumstances. Identification of the Professional Organization That Has Shown Interest in the Policy It is universally acknowledged that nurses possess the high potential to contribute to the development of legislative health care policy by employing a political action. Additionally, those nurses who engage in policy advocacy often do so via participation in their employer’s change policy committees or by supporting already established nursing organizations (Israel, 2013). In other words, professional nursing organizations are believed to have processes and mandates for nurses to engage at one point in policy implementation. However, it is universally acknowledged that, despite the existence of some professional nursing organizations dealing with policy advocacy, it is still very challenging to encourage somehow professional nurses to be involved in politics actively and in the process of healthcare policy implementation for their very own known reasons. One major reason is the fact that most of the registered nurses believe that their primary role is to take care of patients hence failing to look at the greater picture which may include policy making (Israel, 2013). This policy making process intends to collaborate with a professional nursing organization that is working towards the same objective of legislative policy advocacy. One best way of involving other members of the nursing profession is concerning an organization that encompasses nurses that are members of the ICN-International Council of Nurses (Israel, 2013). For instance, United Kingdom’s Royal College of Nurses (UKRCN) has already expressed interest in joining in the implementation of the legislative health care policy. UKRCN expressed its desire to get involved in the policy advocacy because it has established the tendency to give nurses a voice at the national level. At the same time providing nurses tools to have an impact on matters involving decision making and support on how to be active politically and lobby the top political leaders(Israel, 2013). CBR principles and how to approach and collaborate with the interested organization and how their goals align with the policy In community-based participatory research, it is acknowledged that partnerships provide an opportunity to bring together willing individuals who might not have a chance to work and collaborate and in so doing, it increases the participant’s skills (Israel, 2013). Given the fact that United Kingdom’s Royal College of Nurses (UKRCN) aims at giving nurse practitioners a voice regarding to policy making matters, it was very easy approaching them to (or “intending to”) advocate for the legislative policy. Their goal and objective of advocating for the rights of the nurses when it comes to patient care in political matters are very similar to the objective of the legislative policy advocacy. One of the essential elements that will ensure the success of the policy making process goals is effective leadership and proper management structure (Israel, 2013). Actions steps to ensure success The project leader will ensure that all the participating partners comprehend that their contributions to policy making are equally important. Therefore, there is a need to stress the participant’s equality so as to make both the uneducated and very educated members to feel free to work with each other. Moreover, clear and efficient communication of instructions and project requirements will be adequate for the realization of the policy making goals and objectives Developing a unit of identity demands that the partners involved need to commit the emotional energy required to establish interpersonal and inter-organizational relationships. In this case, some of the partners from the organization including the supporting staff may be volunteering their availability and energy to get involved in the policy advocacy project and adding resources and time for the social element which adds unfunded time commitment for them (Israel, 2013).. In other words, this time, element relationships among organizations workers will be very crucial in the success of the legislative policy advocacy. It should be discussed and explained openly to all the participating staff members of United Kingdom’s Royal College of Nurses (UKRCN) as well as the legislative leaders, and nurses are participating in the policy making process. Roles and responsibilities It is acknowledged that not everybody possess equal skills to others. Therefore, those individuals who choose to work independently would, therefore, be required to help in the collection of data from patients and their families. In such cases, the board members of the policy making partnership will have to draft a list of participants who are willing to aid in the policy implementation process. Capacity building activities and project capacity building team will include registered nurses, project investigators, health care experts, academician, gerontology nurse, and the assisted living nurses from both sides of the partnership. Primary elements of developing a collaborative evaluation plan The joint assessment plan will be developed using the following key elements and guiding principles. The first working and guiding principle of partnering with the United Kingdom’s Royal College of Nurses (UKRCN) is acknowledging the collaboration as a unit of identity. In other words, this character can be created as a condition for funding the research (Israel, 2013). Another guiding principle that will ensure that the collaboration with the organization is swift and efficient is establishing or forming a legal corporate identity. However, our collaboration with the United Kingdom’s Royal College of Nurses (UKRCN) did not necessarily need to take this path because there was no need to hire researchers and their staffs, sign space rental contracts or perform any other activities that are typical of start-up partnerships. In such cases, the joint evaluation plan may be built on the resources and the strengths of the participants in the policy making process. In simple terms, promoting a core-learning as well as capacity building among the participating partners is also crucial in determining the collaboration evaluation plan (Israel, 2013). Evaluation plans process The best approach that can be used in this process is the bottoms-up approach. It assumes that the people on the ground or rather at the household level can generate knowledge and skills based on their very own frameworks and categories before the information is passed to the top management level which in this case, is the local political leader, Honorable Donald Trumpet. In other words, people at the household level will be essential in delivering and producing more accurate and richer data that will help in establishing precise results of the inquiry process. As a consequence, will assist in stabling greater commitment to the legislative health care policy and their commitment to change (Chiranjeewee & Harald, 2011). One of the advantages of bottoms –up approach is that people can identify what affects them most and in the process, they can identify with the policy making process decisions. Analysis of the strengths and challenges of the bottoms-up approach and the Top-bottoms approach Advantages of Top-bottoms evaluation process The policy making process realizes a total employment of resources from the applications managed by individuals at the household level (Chiranjeewee & Harald 2011).Additionally, the first stage of implementation acts as a guiding principle of the policy making process. Moreover, after completing the policy-making process, this approach is believed to help in the implementation of more mature, accurate, and broad system solutions Disadvantages of top bottoms approach It is believed that this approach provides a limited coverage during its first phases of implementation. Additionally, a subtle percentage of policies affecting the user accounts are managed during its first implementation stages (Chiranjeewee & Harald, 2011). Moreover, it requires individuals at the household level to adapt to the ongoing implementation process during its first phase. Furthermore, the community will not realize the importance of the policy rapidly. Besides, the cost of implementation as far as resources and time involved are more likely to be higher. Merits of Bottoms-up approach Benefits of the policy are realized during its first implementation –phases because the users are aware of the policy at the household level. Additionally, there is no need for developing custom adapters for its users since they helped in the formulation of the policy (Chiranjeewee & Harald 2011).Moreover, during the first phase, the participants, as well as the organization, broadens its identity skills and understanding of the policy Disadvantages of the bottoms-up approach The policy making process may have to undergo some changes during a later roll-out phase. Additionally, because the users at household level will start feeling the implication of the policy during its earlier stages, the roll-out stage may cause severe adverse consequences (Chiranjeewee & Harald 2011).Moreover, it is driven by existing demands and structures at the community level rather than the policy-making process itself. Analysis of the best approach Given the fact that, the objective of the policy is to benefit patients by the nursing care, bottom-up approach is the best alternative because it produces earlier benefits to the users, and there is high visibility of changes (Chiranjeewee & Harald, 2011). Additionally, bottoms-approach approach causes greater impact to the organization regarding returns and high deployment coverage during its early phases of implementation. Therefore as compared to a top-bottoms approach which has delayed returns and lower impact on the users and the organization, bottoms approach is a much better alternative given limited resources and time. References Chiranjeewee K. & Harald V., (2011).Comparing a top-down and bottom-up approach in the identification of criteria and indicators for sustainable community forest management in Nepal. Retrieved from: http://forestry.oxfordjournals.org/content/85/1/145.full?sid=8ecb647d-3306-47a1-ab77-b3404c68e8a6 Hofrichter, R., Bhatia, R., & National Association of County & City Health Officials (U.S.). (2010). tackling health inequities through public health practice: Theory to action. Oxford: Oxford University Press. Israel, B. A. (2013). Methods for community-based participatory research for health. San Francisco: Jossey-Bass.