2013 Instructors Manual for Policy and Politics in Nursing and Healthcare, 6e

2013 Instructors Manual for Policy and Politics in Nursing and Healthcare, 6e

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Mason: Policy & Politics in Nursing and Health Care, 6th Edition Introduction to Instructor's Manual Alma Dixon This manual is designed to guide and support faculty who are responsible for teaching courses for undergraduate nursing students about policy and politics. Although students will be focused on developing their skills as novice clinicians, it is vital they also recognize the roles policy and politics play in patient care, the health system, and human health. Learning about policy and politics will draw students’ attention to many issues in the health system and to learn about how they can play a role in addressing problems. Major problems that exist today include: • The unsustainable high cost of care • Health care and medical errors • Inadequate access to care • The shortage of nursing faculty needed to prepare an adequate nursing workforce • An insufficient primary care and public health workforce • Significant disparities in access to care • An inadequate focus on prevention of disease • An economy in recession Learning Outcomes The Essentials of Baccalaureate Education for Professional Nursing Practice (AACN, 2008) includes a policy as an essential part of nursing curriculum through Essential V (Healthcare Policy, Finance, and Regulatory Environments). The following outcomes are suggested as guideposts for course activities. If you are able to determine that these learning outcomes were met in prior courses, your task as the instructor will be to reinforce prior knowledge.

Upon completion of this course, the student will be able to: 1. Demonstrate basic knowledge of health care policy, finance, and regulatory environments, including local, state, national, and global health care trends.

2. Describe how health care is organized and financed, including the implications of business principles, such as system cost factors.

3. Compare the benefits and limitations of the major forms of reimbursement on the delivery of health care services.

4. Examine legislative and regulatory processes relevant to the provision of health care.

5. Describe state and national statutes, rules, and regulations that authorize and define professional nursing practice.

6. Explore the impact of sociocultural, economic, legal, and political factors influencing health care delivery and practice.

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Introduction

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7. Examine the roles and responsibilities of regulatory agencies and their effect on patient care quality, workplace safety, and the scope of nursing and other health care professionals’ practice.

8. Discuss the implications of health care policy on issues of access, equity, affordability, and social justice in health care delivery.

9. Use an ethical framework to evaluate the impact of social policies on health care, especially for vulnerable populations.

10. Articulate through a nursing perspective issues concerning health care delivery to decision makers within health care organizations and other political arenas.

11. Participate as a nursing professional in political processes and grassroots legislative efforts to influence health care policy.

12. Advocate for patients and the nursing profession.

This manual is designed to be used with Policy & Politics in Nursing and Health Care (6th edition). Some chapters are noted to be as Highly Recommended reading for all students.

These are the core chapters that address foundational content in policy and politics. Some chapters are noted to be Suggested; these contain important content and can be assigned based on the overall design of the course. Other chapters are identified as Optional; these may be assigned based on individual student interest and learning needs.

The learning outcomes and teaching strategies are designed for specific units instead of individual chapters. This allows instructors to focus on the broader concepts that will enable students to apply the knowledge to their clinical experiences and theory learned in prior nursing courses. Throughout this manual, the emphasis is on application of knowledge rather than memorization of content. Therefore, chapters entitled “Taking Action” have educational strategies specifically designed to encourage students to select an area of interest and apply the skills learned to their clinical practice, experience, and knowledge. Each unit contains Websites that both instructors and students may use to complete assignments and keep abreast of the changes in a rapidly evolving health care system.

Policy & Politics in Nursing and Health Care (6th edition) is designed for use across nursing curricula from undergraduate education to graduate preparation at the Master’s and Doctorate levels. This manual begins the process by suggesting teaching strategies that lay the foundation for future study for students who will pursue advanced degrees. For students who do not advance their education, it suggests educational approaches that expose them to the major challenges that nurses have always embraced, and that is to effect change for patients by exercising our single and collective voices on behalf of the most vulnerable and often disenfranchised members of our society.

References American Association of Colleges of Nursing. (2008, October 20). The Essentials of Baccalaureate Education for Professional Nursing Practice. Washington DC: American Association of Colleges of Nursing.

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Mason: Policy & Politics in Nursing and Health Care, 6th Edition Orientation Class to Policy and Politics in Nursing and Health Care Alma Dixon The following is an activity that can be used to stimulate students’ early thinking about political activity and engagement.

Directions: Distribute the Checklist (Table 1-1) to students. Direct them to complete the checklist individually. Divide the class in groups and have them discuss the following, based on their checklist responses.

1. Do you consider yourself to be politically active? Why or why not?

2. Do you feel that you are knowledgeable of the political process?

3. Should nurses be politically active? Why or why not?

4. How can nurses make a difference in the health of their patients and the public by shaping policy?

5. What do you hope to learn during this course?

A recorder may be appointed to take notes so that students can compare their views from the beginning of the course to their views at the end of the course.

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Orientation Class

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Engagement and Political Voice Checklist For each item, check the box that applies Never to you. For the item on vote registration, use the “Yes” or “No” boxes.

I work to solve community problems I volunteer regularly for an environmental group I volunteer regularly for a civic or community organization I volunteer regularly for any other organization I belong or donated money to any group or organization Besides donating money, I help raise money for charitable causes

Sometimes

Always

Yes

No

I have registered to vote I vote in elections (regular voting) I volunteer for a political campaign or candidate I encourage others to vote I wear a campaign button or have a sticker on my vehicle I volunteer for a candidate, work or contribute money to a political party, or an organization that supports candidates I contacted/visit public officials I contact a newspaper or magazine I contact a radio or television news show I protest I sign an e-mail petition I sign a written petition I boycott companies I buy something to support the values of a company Adapted from Dahl, I., Hoy, A., Meisel, W. (Eds. of the Corella and Bertram F. Bonner Foundation.) (2006). From community service to political action: A student call for civic engagement. Princeton NJ: The Bonner Foundation.

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Mason: Policy & Politics in Nursing and Health Care, 6th Edition UNIT 1: INTRODUCTION TO POLICY AND POLITICS IN NURSING AND HEALTH CARE Alma Dixon Highly Recommended Chapters: Chapter 1: A Framework for Action in Policy and Politics Chapter 2: A Historical Perspective on Policy, Politics, and Nursing Chapter 3: Learning the Ropes of Policy, Politics, and Advocacy Chapter 4: Taking Action: How I Learned the Ropes of Policy and Politics Chapter 7: The Policy Process Chapter 8: Political Analysis and Strategies Chapter 11: Communication Skills for Success in Policy and Politics Suggested Chapters: Chapter 5: Advocacy in Nursing and Health Care Chapter 9: Health Policy, Politics, and Professional Ethics Chapter 12: Conflict Management in Health Care: The Tipping Point Arrives Optional Chapters: Chapter 6: A Primer on Political Philosophy Chapter 7: The Policy Process Chapter 10: Using the Power of Media to Influence Health Policy and Politics UNIT OVERVIEW: The content in Unit 1 may not have been presented in other nursing courses; therefore, it is fundamental to understanding policy and politics and the role that a baccalaureate prepared graduate nurse may play. It begins with an overview of the new Patient Protection and Affordable Care Act (PPACA) and its potential to reform the health care system and how health care is delivered. It also contains the review of various types of policies and the forces that shape health policy. The components of the often maligned, but critical political skill behaviors are also presented as well as the actions inherent in policy analysis, advocacy, and political activism. The “Framework for Action,” which was first introduced in Political Action Handbook for Nurses: Changing the Workplace, Government, Organizations and Community (Mason & Talbott, 1985) is expanded and updated to focus on the current spheres of influence, namely, the community, the workforce and workplace, the government, and the associations and interest groups.

The historical perspective on policy, politics, and nursing lays the foundation for students to understand the role of nurses’ activism to advance the profession as well as health care. In addition, the unit describes how the formation of the professional associations placed nursing as a strong force in addressing the social and political reforms affecting society in the 1800s.

The beginning tension between nursing and the advancement of women in society is also

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UNIT 1

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reviewed in tandem with the discriminatory practices inherent in society and nursing during the early 1900s. The impact of public health nursing as a vehicle to address the problems associated with urbanization, industrialization, and immigration is reviewed as well as the relationship between the suffrage movement, organized nursing, and modern nursing.

In practice, the baccalaureate prepared graduate is expected to advocate for vulnerable populations. This unit contains detailed information on advocacy in nursing that can be applied to the clinical setting. A case study is provided to illustrate the material that was presented.

RELEVANCE FOR STUDENTS: This unit provides the content to either introduce or broaden understanding of the complexities of the United States health care system and the need for fundamental changes in the way resources are allocated. It supplies the historical context of nursing in shaping policy and the transforming changes that will result from the enactment of health care reform. This information is important as students learn about the roles they will play as nurses and as concerned citizens.

LEARNING OBJECTIVES 1. Identify the impact of the Patient Protection and Affordable Care Act (PPACA) on health care reform.

2. Explain how values and politics shape health policy.

3. Identify the components of political skill and the implications for nurses.

4. Explain how policy analysis, advocacy, interest groups, lobbyists, and the media play a role in health care and nursing.

5. Describe the Framework for Action including the spheres of influence (the community, the workforce and workplace, the government, and the associations and interest groups).

6. Discuss the present and historical application of nursing as “a metaphor for the struggle for equality of women.”

7. Explain how political activism has influenced the profession of nursing and the delivery of health care.

8. Identify the steps in political analysis and how they may be applied to an issue in the workplace or how to advocate for clients.

9. Identify the communication skills needed to be effective in professional and political arenas.

TEACHING STRATEGIES The spheres of influence provide a practical framework to organize teaching strategies that will enable students to learn about political action through application of knowledge.

Therefore the strategies are organized around the community, the workforce and workplace, the government, and associations and interest groups. Depending on the student evaluation system used, faculty may consider allocating specific points for each step within each assignment. In addition, criteria with suggested point allocations are provided to assist in the evaluation.

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UNIT 1

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Sphere of Influence 1: The Community Small Group Assignment Purpose: To provide students with experience in influencing policy at the community level.

Instructions: Divide the class into groups of 4 to 6 with instructions that each group should complete the same task.

Vignette Provided to Students: You are completing a clinical rotation in a small community agency that provides services to pregnant women or women with children under the age of 3 in an urban area of the southern United States. The racial composition of the community is 78.1% white, 9.6 % African American, 8.0% Hispanic, 0.3% American Indian/Alaska Native, 2.0% Asian, and 2.0% other. In 2009, 110,800 women of childbearing age resided in the county with 5,300 total births.

Recently you and your fellow students learned that current statistics for the county reveal that from 2006 to 2008, the infant mortality (number of deaths per 1000 live births) rate was 8.2%; an increase from 6.5% in 2005-2007. For African Americans, the rates were 10.0% in 2005 to 2007 and increased to 14.4% in 2006 to 2008. The local Healthy Start agency confirms that these data are accurate for the community. In fact, based on a review of deaths by the coroner, in the last year, the major causes of neonatal and infant demise were low birth weight, babies sleeping in bed with an adult (roll over/unintentional deaths), and SIDS. Task: You and your classmates decide to take action. With the assistance of the staff from the agency and your nursing faculty, you decide to develop a community awareness campaign.

The Assignment: 1. Name your campaign.

2. Identify community partners to help with your campaign.

3. Identify the stakeholders.

4. Name the resources you will need.

5. Establish a task list.

6. Assign responsibilities.

7. Define a timeline.

8. Describe an evaluation process.

Evaluation Criteria You will be evaluated on: 1. Your ability to creatively engage the interest of the community by the name of the campaign………………………………………………………………………10 points 2. Your understanding of the community partners and stakeholders needed to ensure success of your campaign…………………..………………………30 points 3. Your ability to cite the extent of the resources needed and the time frame to develop the community awareness campaign………….…………………20 points 4. Your knowledge of the steps involved in evaluating the success of your campaign or what is needed to improve in the future……………………………..40 points

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UNIT 1

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Sphere of Influence 2: The Workforce and Workplace: Small Group or Individual Writing Assignment Purpose: To provide the experience for students to develop a policy that impacts the workforce or the workplace.

Instructions: Students select a current problem, for example, the inability of the profession to establish the BSN as a minimum requirement for entry into practice, or the shortage of nurses in the United States. Using the “Steps of a Political Analysis” found in Box 8-1 as a guide, complete the following assignment: 1. Identifying and analyzing the problem 2. Outlining and analyzing proposed solutions 3. Understanding the background of the issue: its history and previous attempts to address the problem 4. Locating the political setting and structures involved 5. Evaluating the stakeholders 6. Conducting a values assessment 7. Recognizing the resources (both financial and human) needed to reach the intended goals 8. Analyzing the power bases

1.

2.

3.

4.

5.

6.

7.

8.

9.

Evaluation Criteria You will be evaluated on your ability to complete the following tasks according to points designated: Identify and analyze the problem…………………………………………..10 points Outline and analyze proposed solutions………………………………….10 points Explain the background of the issue including its history and previous attempts to address the problem…………………………………………………………..10 points Identify the entities that have jurisdiction over the problem………………10 points Identify the stakeholders and their potential roles in addressing the problem…10 points Name the inherent values that need to be assessed………………………10 points Determine the resources, both financial and human, needed to bring the issue forward and to reach a resolution……………………………………………...10 points Analyze the power bases……………………………………………………….10 points Design a plan of action based on your political analysis…………………….20 points

Sphere of Influence 3: The Government Writing Assignment Purpose: To provide the opportunity for students to practice influencing policy by communicating with a legislator about a current health problem.

Instructions: Have students complete the following steps: 1. Select a current health problem that is being debated at the national and/or state level (e.g., the proliferation of “pill mills” and pain clinics), and state why it is of interest.

2. Identify a legislator (state or federal) and state why that person is the appropriate one to contact.

3. Draft a letter to the legislator including the proper salutation.

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4. Introduce yourself and your reason for writing.

5. State concisely what you understand to be the current socioeconomic, political, and ethical issues surrounding the problem.

6. Discuss the implications of the problem for nursing or nursing practice.

7. Make a clear request for action.

8. Request a response.

Evaluation Criteria You will be evaluated on the following criteria: 1. Identification and description of a current health problem………………20 points 2. Identification of a legislator and the reason for your selection…………………………………………………………………20 points 3. Preparation of a concise letter that cites the current socioeconomic, political, and ethical issues surrounding the problem as well as the implications of the problem for nursing or nursing practice………….30 points 4. Your ability to determine an appropriate action and make a request for that action ………………………………………………………………………30 points Sphere of Influence 4: Associations and Interest Groups Writing Assignment Purpose: To provide the opportunity for students to become familiar with different nursing associations.

Instructions: Have students complete the following steps: 1. Choose a nursing association.

2. List the mission and purpose of the association 3. How is it governed?

4. What is the legislative agenda of the association?

5. How is that agenda developed? Is the membership involved?

6. How is the agenda communicated to the membership?

7. Does it partner with any coalitions?

8. Does the partnership influence policy on a national or state level? If yes, how?

9. When you graduate will you join the association? If yes, why? If no, why not?…………………….

Evaluation Criteria After you have selected a nursing association, you will be evaluated on your ability to answer the following: 1.

2.

3.

4.

5.

6.

7.

What is the mission and purpose of the association?................10 points How is it governed? ...................................................................10 points What is the legislative agenda of the association? ...................10 points How is that agenda developed? ................................................15 points Is the membership involved?........................................................5 points How is the agenda communicated to the membership?...............5 points Does it partner with any coalitions?.............................................10 points

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UNIT 1

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8. Does the partnership influence policy on a national or state level? If yes, how? ........15 points 9. When you graduate, will you join the association? If yes, why? If no, why not? 20 points Optional Assignment Writing Assignment Purpose: To provide the opportunity for students to select an area of interest in policy and politics and apply the knowledge to their clinical practice, experience, and knowledge.

Instructions: Students may select a chapter and answer the following: 1. Why did you select this case study?

2. How does it relate to what you understand or have learned about policy and politics in nursing and health care?

3. How does it relate to your current clinical practice? Give at least one specific example.

4. How does it relate to what you hope to accomplish in nursing practice?

Evaluation Criteria You will be evaluated on your ability to apply the knowledge from the chapters in Unit 1: Introduction to Policy & Politics in Nursing & Health Care by answering the following questions: 1. Why did you select the case study “Taking Action: Advocacy in Nursing and Health Care?”………………………………………………………………….20 points 2. How does it relate to what you understand or have learned about policy and politics in nursing and health care?...............................................................30 points 3. How does it relate to your current clinical practice?..................................25 points 4. How does it relate to what you hope to accomplish in nursing practice?..….25 points

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Mason: Policy & Politics in Nursing and Health Care, 6th Edition UNIT 2: HEALTH CARE DELIVERY AND FINANCING Alma Dixon Highly Recommended Chapters: Chapter 13: The United States Health Care System Chapter 16: A Primer on Health Economics Chapter 21: The Uninsured and Underinsured—On the Cusp of Health Reform Chapter 22: Policy Approaches to Address Health Disparities Chapter 29: Chronic Care Policy: Medical Homes and Primary Care Suggested Chapters: Chapter 14: Financing Health Care in the United States.

Chapter 17: Reforming Medicare Chapter 18: Children’s Health Insurance Coverage: Medicaid and the State Children’s Health Insurance Program Chapter 24: Long-Term Care Policy Issues Chapter 25: Home Care and Hospice: Evolving Policy Optional Chapters: Chapter 15: Could a National Health System Work in the United States?

Chapter 19: The United States Military Health System: Policy Challenges in Wartime and Peacetime Chapter 20: The Veterans Administration Health System: An Overview of Major Policy Issues Chapter 23: The Rural Health Care Tundra Chapter 26: Achieving Mental Health Parity Chapter 27: Integrative Health: Pathway to Health Reform and a Healthier Nation Chapter 28: Nursing’s Influence on Drug Development and Safety Chapter 30: Family Caregiving and Social Policy Chapter 31: Health Care Clinics: Filling a Gap in the Health Care System Chapter 32: Nurse-Managed Health Centers Chapter 33: Community Health Centers: Successful Advocacy for Expanding Health Care Access Chapter 34: Taking Action: Setting Health Care in Its Social Context Chapter 35: Taking Action: Reimbursement Issues for Nurse Anesthetists: A Continuing Challenge Chapter 36: The Role of Foundations in Improving Health Care Chapter 37: Social Security: Key to Economic Security Chapter 38: The United Kingdom’s Health System: Myths and Realities UNIT OVERVIEW Unit 2 begins with defining the complexities of health care in the U.S. including the multiple

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UNIT 2

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interacting components, multiple stakeholders with differing goals and visions, and multiple consumers with different needs and wants. It expands on the Patient Protection and Affordable Care Act (PPACA) introduced in Unit 1 and explains how components of the Act will be used to finance health care reform.

The unit continues with a discussion of the application of economic theory to health care. It also contains topics related to the demand for and supply of health care, the markets for hospitals and nurses, the evaluation of costs and benefits of specific health care policies, and the future of the health care system.

The unit also explores the impact of current health care financing and access to care for the most vulnerable citizens (infants, children, and older adults).

RELEVANCE FOR STUDENTS: This chapter provides the opportunity to either introduce or reinforce the content to baccalaureate generalist nurses related to the complexities of the health care system and the need for fundamental change in the way resources are allocated. It supplies the historical context of nursing in shaping policy and the transformative changes that will result from the enactment of health care reform. This information is important as students learn about the roles they will play as nurses and as concerned citizens.

LEARNING OBJECTIVES 1. Define the roles of patients, providers, and funding sources as fundamental to understanding the complexities of the current health care system and examine if reform is needed.

2. Discuss the implications of health care policy on issues related to access, equity, quality, and cost.

3. Examine the impact of limited access to care by the uninsured, underinsured, and vulnerable populations such as infants, children, and older adults.

TEACHING STRATEGIES Small-Group or Individual Writing Assignment Purpose: To provide students with the opportunity to design a health system that addresses a specific health care problem and implements a significant component of Patient Protection and Affordable Care Act (PPACA).

Instructions: For this assignment, students may incorporate Box 13-2, “Six Drivers of High Performance Health Care Systems” into their responses.

1.

2.

3.

4.

5.

6.

7.

8.

Choose a health care problem.

Choose a community, or select an age group most impacted by the problem.

Design a Medical Home (Health Home) for patients identified in #2.

Who is the current primary care provider and why?

Who is the primary care provider in your Medical Home (Health Home) and why?

What specialists currently are needed, and what is the accessibility?

How will specialists be handled in your Medical Home (Health Home)?

How is access to medical information currently handled?

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UNIT 2

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9. How will you ensure that clients have easy access to medical information in your Medical Home (Health Home)?

10. How will you inform the community about your Medical Home (Health Home)?

11. Who are the stakeholders you need to get on board?

12. What opposition do you project will occur with the opening of the Medical Home (Health Home)?

Evaluation Criteria You will be graded on the following criteria: 1) Your choice of a health care problem……………………………………..20 points 2) Your ability to choose a community or select an age group most impacted by the problem………………………………………………………………………..20 points 3) Your creativity to design a Medical Home (Health Home) for patients identified in #2 and to determine the following: …………………………………………40 points • The current primary care provider and why you identified that person • The primary care provider you select for Medical Home (Health Home) and why • The specialists currently needed and the accessibility to the specialists • How the specialists will be handled in your Medical Home (Health Home) • How the access to medical information is currently handled • How you will ensure that clients have easy access to medical information in your Medical Home (Health Home) 4) Your ability to engage the community by determining the following: ....40 points • How you will inform the community about your Medical Home (Health Home) • The stakeholders you need to get on board • The opposition you project to opening the Medical Home (Health Home) Writing Assignment: Purpose: To provide students with experience to reflect on their personal views related to the role of government and access to care for the uninsured.

Instructions: Students are to write an essay in agreement or opposition to the following: “It was once said that the moral test of government is how that government treats those who are in the dawn of life, the children; those who are in the twilight of life, the elderly; and those who are in the shadows of life, the sick, the needy, and the handicapped.”

Hubert H. Humphrey, United States politician (1911-1978) 1. Do you agree or disagree with this statement? Why or why not?

2. State your reasons based on your knowledge of the health care system, observations in the clinical area, and personal experience. Justify your responses with appropriate resources.

Evaluation Criteria You will be graded on the following criteria: 1. Your ability to state a position and explain the reason for the choice….30 points

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UNIT 2

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2. Your ability to demonstrate an understanding of the relevance of the quote to the role of government and access to care for the uninsured…………40 points 3. Your ability to organize your thoughts and complete a well written, clear, and readable paper with justification……………………………………………………..…30 points Group Assignment: Purpose: To provide students with the opportunity to explore a current health legislative issue that relates to a health disparity at the state or national level.

Instructions: The student is expected to perform a thorough search of the literature, the media, and discussions with stakeholders such as legislators, consumers, and other health care professionals about a current health legislative issue. Students will participate on a panel that will present the following areas or the selected health issue: 1. What is the current legislative or regulatory issue, and why is it being debated?

2. Who is most affected by the legislation?

3. What are the current socioeconomic, political, cultural, and ethical issues surrounding this topic?

4. Who are the stakeholders?

5. What are the positions of professional health care organizations (ANA, AHA, AMA), consumers, and the major political parties on the issue?

6. What are the implications of the policy issue for nursing?

Evaluation Criteria You will be graded on your ability to respond to the following questions in a comprehensive manner that demonstrates an understanding of the legislative process as part of a panel discussion that focuses on the selected health disparity and the implications of the policy for nursing.

1. What is the current legislative or regulatory issue, and why is it being debated?............................................................................10 points 2. Who is most affected by the legislation? …………………………………….10 points 3. What are the current socioeconomic, political, cultural, and ethical issues surrounding this topic?……………………………………………………………10 points 4. Who are the stakeholders?...........................................................................5 points 5. What are the positions of professional health care organizations (ANA, AHA, AMA), consumers, the major political parties, and nurses on the issue?.............10 points 6. What are the implications of the policy issue for nursing?..........................15 points 7. Participation on the panel…………..………………………………………..…20 points 8. Clarity, organization of the presentation………………………………………………………………………..20 points Optional Assignment Writing Assignment Purpose: To provide the opportunity for students to select an area of interest and apply the knowledge about health care delivery and financing to their clinical practice, experience, and knowledge.

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UNIT 2

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Instructions: Step 1: Student may select one of the following chapters: Chapter 34: Taking Action: Setting Health Care in Its Social Context Chapter 35: Taking Action: Reimbursement Issues for Nurse Anesthetists: A Continuing Challenge Step 2: Answer the following questions: 1. Why did you select the chapter?

2. What did you learn about the role of the nurse as an activist?

3. What problems were encountered?

4. Would you have approached the problem differently? If so, how? If not, why not?

5. What did you learn from the chapter about health care delivery and financing?

6. Would you suggest another policy as an outcome? If yes, what would it be? If not, why not?

Evaluation Criteria You will be graded on your ability to apply the knowledge from the chapters in Unit 2: Health Care Delivery and Financing by answering the following questions: 1. Why did you select the chapter?.......................................................10 points 2. What did you learn about the role of the nurse as an activist?.........15 points 3. What problems were encountered?..................................................15 points 4. Would you have approached the problem differently? If so, how? If not, why not? ............................................25 points 5. What did you learn from the chapter about health care delivery and financing? …………………………………………………………………………………20 points 6. Would you suggest another policy as an outcome? If yes, what would it be? If not, why not?.....................................................................................15 points

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Mason: Policy & Politics in Nursing and Health Care, 6th Edition UNIT 3: POLICY AND POLITICS IN RESEARCH AND NURSING SCIENCE Alma Dixon Highly Recommended Chapters: Chapter 39: Science, Policy, and Politics Chapter 40: Research as a Political and Policy Tool Suggested Chapters: Chapter 42: Politics and Evidence-Based Practice and Policy Chapter 43: The Society for Women’s Health Research: Using Evidence-Based Policy to Improve Health Chapter 44: Using Research to Advance Healthy Social Policies for Children Optional Chapters: Chapter 45: Taking Action: Reefer Madness: The Clash of Science, Politics, and Medical Marijuana Chapter 46: Taking Action: The Journey into the Hallowed Halls of Politics: How Nurse Practitioners Changed Pennsylvania Policy UNIT OVERVIEW Unit 3 begins with explaining how science and politics interact and influence each other and how science can influence policy. Several examples illustrate how research can be ignored or misused for political gain.

Included in the unit are examples of current controversial research areas that have policy implications. These examples highlight the use of many strategies that are included in Units 1 and 2 that nurses have used to advance evidence-based research to accomplish changes in policy.

RELEVANCE FOR STUDENTS: This chapter provides the content for students to understand how research can be used or misused in political decisions. This places the importance of being a knowledgeable consumer of research in the context of the role of the nurse as patient advocate and patient educator.

LEARNING OBJECTIVES 1.

2.

3.

4.

5.

Describe the relationship of politics and the political process to research.

Describe how politics and science may clash and the impact on patients and nursing.

Cite how science can be used to inform policy and political decisions.

Identify research in the policymaking process.

Cite the impact of gender inequity in research and the subsequent effect on health care policy.

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UNIT 3

2

6. Identify major themes pertaining to social policies for children and the impact of research on those policies.

7. Identify the role of nursing in advancing controversial research projects using medical marijuana and screening for Chlamydia as paradigms.

TEACHING STRATEGIES Writing Assignment Purpose: To provide students with the opportunity to explore the interface of political influence and a major health issue using tobacco use as a paradigm.

Instructions: Students are to complete the following steps including answering questions: 1. Trace the history of smoking and its effect on health (locate an article from a nursing journal on the hazards of smoking).

2. Who were the stakeholders in opposition to smoking?

3. Who were the lobbyists in favor of a hands-off approach?

4. What is the current use of tobacco products (e.g., smokeless tobacco)?

5. What is the current research on the use of these products?

6. What are the policy implications?

Evaluation Criteria After you locate an article from a nursing journal on the hazards of smoking, you will be evaluated on your ability to thoroughly answer the following questions in a coherent, wellwritten paper.

1. Who were the stakeholders in opposition to smoking?.......10 points 2. Who were the lobbyists in favor of a hands-off approach?.....10 points 3. What is the current use of tobacco products (e.g., smokeless tobacco)?….10 points 4. What is the current research on the use of these products?.............10 points 5. What are the policy implications for the future?........................................................30 points 6. Paper: organization, grammar, resources/references ………………………………………………………………………30 points Writing Assignment Purpose: To provide the opportunity for students to compare and contrast the roles, scope of practice and perspectives of nurse practitioners and physicians and suggest a policy intervention Instructions: Students are to complete the following steps including answering questions: 1. Select a specialty (e.g., family practice, pediatrics). Define the roles you will be addressing: physician and nurse practitioner.

2. Determine who regulates the scope of practice for the physician and the NP. 3. Summarize the scope of practice including the level of autonomy for each.

4. What are the barriers to practice?

5. What policy change would you suggest?

Evaluation Criteria You will be evaluated on your ability to: 1. Select a specialty (e.g., family practice, pediatrics)…………………..10 points

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2. Determine who regulates the scope of practice for the physician and the NP…………………………………...10 points 3. Summarize the scope of practice including the level of autonomy for each……20 points 4. Identify the barriers to practice…………………………………………….15 points 5. Suggest a policy change……………………………………………………20 points 6. Present a well-written, concise paper……………………………………..25 points Optional Assignment Writing Assignment Purpose: To provide the opportunity for students to select an area of personal interest in policy and politics in research and nursing science Instructions: Step 1: Student may select one of the following chapters: Chapter 45: Taking Action: Reefer Madness: The Clash of Science, Politics, and Medical Marijuana

Chapter 46: The Journey into the Hallowed Halls of Politics: How Nurse Practitioners Changed Pennsylvania Policy Step 2: Answer the following questions: 1. Why did you select the chapter?

2. What did you learn about the role of the nurse as an activist?

3. What problems were encountered?

4. What might you have done differently to address the problem? Why? If you would not have done anything differently, why not?

5. What did you learn from the chapter about politics in research and nursing science?

6. Would you suggest another policy as an outcome? If yes, what would it be? If not, why not?

Evaluation Criteria You will be evaluated on your ability to apply the knowledge from the chapters in Unit 3: Policy and Politics in Research and Nursing Science, by answering the following questions: 1.

2.

3.

4.

5.

Why did you select the chapter?.......................................................10 points What did you learn about the role of the nurse as an activist?.........15 points What problems were encountered?..................................................15 points What might you have done differently? ............................................25 points What did you learn from the chapter about politics in research and nursing science? ….………………………………………………………………20 points 6. Would you suggest another policy as an outcome? If yes, what would it be? If not, why not?.....................................................................................15 points

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Mason: Policy & Politics in Nursing and Health Care, 6th Edition UNIT 4: POLICY AND POLITICS IN THE WORKPLACE AND WORKFORCE Alma Dixon Highly Recommended Chapters: Chapter 47: Policy and Politics in the Contemporary Work Environment Chapter 49: The Nursing Workforce Chapter 50: Nursing Education Policy: The Unending Debate over Entry into Practice and the New Debate over Doctoral Degrees Chapter 52: Global Nurse Migration Chapter 56: Workplace Abuse in Nursing: Policy Strategies Suggested Chapters: Chapter 48: Quality and Safety in Health Care: Policy Issues Chapter 53: Nurse Staffing Ratios: Policy Options Chapter 61: Collective Bargaining in Nursing Chapter 62: Workplace Advocacy Optional Chapters: Chapter 51: The Politics of Advanced Practice Nursing Chapter 54: Taking Action: Aligning Care at the Bedside with the C-Suite Chapter 55: Taking Action: When a Hurricane Strikes: The Challenge of Crafting Workplace Policy Chapter 57: Taking Action: Advocating for Nurses Injured in the Workplace Chapter 58: Taking Action: Influencing the Workplace by Serving on a Hospital’s Board of Directors Chapter 59: The Intersection of Technology and Health Care: Policy and Practice Implications Chapter 60: The Influence of Magnet Recognition® on Organization and Workplace Policy UNIT OVERVIEW Unit 4 discusses the importance of supporting a workplace culture that supports and rewards efforts to provide safe and quality care. Included in the discussion are the importance of teamwork and effective communication among team members. The use of technology is also included as a tool to improve patient safety, enhance quality outcomes, and reduce workload demands.

The unit also discusses issues related to nursing and the contemporary workforce. There is debate over entry into practice, the politics of advanced nursing practice, global nurse migration, workforce abuse, and collective bargaining.

RELEVANCE FOR STUDENTS: This unit focuses on the realities of the workplace and the issues new graduates will face upon entry into the workforce. The issues related to

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workplace abuse and collective bargaining facilitate decision-making about the type of environment for future employment. Chapters that center on the controversy surrounding global migration and the multiple access points to licensure prepare students for the diversity and possible conflict they will encounter in the workplace.

LEARNING OBJECTIVES 1. Define the interrelationship among quality care, health care teams, technology, and finances in contemporary work environments.

2. Discuss the impact of global migration on the nursing workforce.

3. Discuss the implications of multiple access points to entry into practice.

4. Define a workplace culture of safety.

5. Examine issues related to staffing ratios and collective bargaining.

TEACHING STRATEGIES Writing Assignment Purpose: To provide the students with the experience of examining a contemporary workplace and determine the characteristics of a safe environment.

Instructions: Have students choose a clinical site and complete the following assignment: 1. Name the site.

2. What is the organizational type (e.g., government, not-for-profit)?

3. Describe the units/services within the organization.

4. How is the organization financed?

5. What insurance is accepted?

6. What are the patient demographics?

7. How is quality care defined? Is patient safety part of the definition? Is the term “evidenced-based practice” used in any definitions?

8. How are quality patient outcomes defined and measured?

9. Are awards/rewards given for excellence in patient care? If yes, how are the award recipients determined? To whom are the awards given?

10. Does the environment facilitate communication within health care teams? If yes, how is this accomplished?

11. What technology, if any, is employed in the practice setting? If yes, please give examples of how it is used.

12. What part does nursing play in the selection, use, and evaluation of technology?

13. Are there any policy changes you would suggest? If yes, what are they? If no, why not?

14. Would you seek employment in this institution or one like it?

Evaluation Criteria After selecting a clinical site, you will be evaluated on the following: 1. An understanding of the organizational structure by answering the following questions………………………………………………………………………20 points a) What is the organizational type (e.g., government, not-for-profit, for-profit)? b) Describe the units/services within the organization. c) How is the organization financed? d) What insurance is accepted?

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2. An assessment of quality measurements and the impact on patient care by answering the following questions ………………………………………………………25 points a) What are the patient demographics? b) How is quality care defined? Is patient safety part of the definition? c) How are quality patient outcomes defined and measured? d) Are awards/rewards given for excellence in patient care? If yes, how is it determined?

To whom is it given? e) Does the environment facilitate communication within health care teams? If yes, how is this accomplished? What is the connection to quality care? f) Is the use of technology employed in the practice setting? If yes, explain how it is used. What is the connection to quality care? g) What part does nursing play in the selection, use, and evaluation of technology?

3. An understanding of policy development in the workplace………………….. 25 points 4. A well-written paper that incorporates your observations and the characteristics of the work environment in which you will seek employment…………………...30 points Group Activity Purpose: To provide the opportunity for students to explore the impact of nurse migration of nurses to the U.S. Instructions: Divide the group into subgroups of 5 to 10 students for field trip exercise.

Have students choose a clinical site and complete the following: Interview a nurse recruiter from one of your clinical sites where foreign-born nurses were either recruited in the past (within the last 10 years) or are currently recruited.

Task 1 1. What is the institution’s policy on the recruitment of foreign-trained nurses?

2. If the institution does not currently engage in foreign recruitment of nurses, why not?

3. From what countries are/were the nurses recruited and why?

4. How are/were credentials verified?

5. What programs are/were in place to facilitate transition of these nurses into the United States workplace?

6. Are/were programs on cultural competence incorporated into the orientation phase?

Describe the audience for the programs.

7. What impact did the recruitment of nurses have on the nurse-to-patient staff ratio?

Task 2 Research one of the countries from which the nurses were/are recruited.

Is it a developing or industrialized nation?

What is the health care system like in that country?

What are the major health problems?

What is the educational system for nurses?

Is the country experiencing a nursing shortage?

Task 3 Based on tasks 1 and 2, develop a position paper on the recruitment of nurses from these countries. What policies do you suggest should be implemented or improved?

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Evaluation Criteria Each student in a group is expected to take part in the entire exercise; therefore, each student in a group receives the same evaluation.

Task 1: Impact of foreign nurse migration on an institution in the U.S. ………20 points Task 2: Impact of foreign nurse migration on “source countries”……………..20 points Task 3: Position paper that concisely states a well-documented position on foreign nurse recruitment …………………………………………………………………….30 points Task 4: Policies that are suggested to be implemented or improved…..….30 points Group Activity: Debate Purpose: To provide students with the opportunity to practice the skill of researching a topic, forming a viewpoint, and debating that viewpoint.

Instructions: Divide the class into groups depending on class size. Each group will choose a pro and con subgroup to debate the following topics: Topic 1: Should multiple access points to the profession be allowed for entry into practice?

Topic 2: Do reduced nurse-patient ratios improve patient care?

Topic 3: Should nurses unionize?

Ground Rules: 1. All students in the group are expected to participate in the research, development, and presentation of the debate position.

2. Each student in the group will receive the same group evaluation.

3. Select one person as the spokesperson to debate.

4. Allow adequate time for positions (pro and con), rebuttal, and the summary.

5. Suggest to set a time limit depending on the class length, for example, 1 hour; each side would have a total of 30 minutes to present.

Evaluation Criteria: 1 Poor 5 points

2 Below Average 6 points

3 Average 7 points

4 Above Average 8 points

Overview/summary of position Analysis of the issue Summary: Review of major points; statement of relevance to nursing practice Quality of presentation: Coherence, ability to follow points; quality of transitions between points Creativity Verbal behavior: Clarity, choice of words, voice level to be convincing Nonverbal behavior: Posture, gestures, eye contact Timing: Maintained time limit, used time provided Rebuttal

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5 Outstanding 10 points

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Audience engagement Group Activity: Brainstorming Exercise Purpose: To provide students with the opportunity to generate creative ideas in a spontaneous manner, identify the characteristics of a safe workplace and suggest policy to advocate for a safe work environment.

Instructions: Divide the class into groups of 5 to 10 students.

Distribute the following questions: 1. What constitutes a workplace culture of safety?

2. How do you recognize workplace abuse?

3. What policies should be implemented to prevent workplace abuse?

Provide flip chart and markers.

Explain the rules: 1. Active participation by all students in the group is expected.

2. Appoint a recorder to write all ideas exactly as stated on the poster board where everyone can see them.

3. There are no comments that are silly or don’t make sense.

4. There should be no discussion, criticisms, compliments, or other comments during the exercise.

5. Set a time limit.

6. After everyone has had a chance to express his or her ideas, clarify all comments to make sure all students in the group understand. Remember to clarify the comments only, not make judgments about them.

7. Compile the answers from each group into one document.

At the end of the exercise, based on the comments, have students reflect on the characteristics they will look for in the place they select for employment.

Evaluation Criteria Participation in the exercise……………………………………………………..40 points Willingness to listen without criticism……………………………………………30 points Demonstrate an understanding of the characteristics of a safe workplace…30 points Optional Assignment Writing Assignment Purpose: To provide students with the opportunity to select an area of interest and apply the knowledge about policy and politics in the workplace and workforce to their clinical practice, experience, and knowledge. Specify a length of the paper: 2 to 4 double spaced typed pages Use each question as a heading for the paper.

Instructions: Step 1: Student may select one of the following chapters: Chapter 54: Taking Action: Aligning Care at the Bedside with the C-Suite Chapter 55: Taking Action: When a Hurricane Strikes: The Challenge of Crafting Workplace Disaster Policy Chapter 57: Taking Action: Advocating for Nurses Injured in the Workplace Chapter 58: Taking Action: Influencing the Workplace by Serving on a Hospital’s Board of Directors Step 2: Complete the following questions: Copyright © 2012 by Saunders, Inc., an affiliate of Elsevier Inc.

UNIT 4 1.

2.

3.

4.

5.

6

Why did you select the chapter?

What did you learn about the role of the nurse as an activist?

What problems were encountered?

What might you have done differently?

What did you learn from the chapter about politics in the workplace and workforce?

Evaluation Criteria You will be evaluated on your ability to apply the knowledge from the chapters in Unit 4: Policy and Politics in the Workplace and Workforce by answering the following questions: 1. Why did you select the chapter?………………………………15 points 2. What did you learn about the role of the nurse as an activist?……25 points 3. What problems were encountered?………………………….15 points 4. What might have you done differently?......................................15 points 5. What did you learn from the chapter about politics in the workplace and workforce?....................................................................................30 points

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Mason: Policy & Politics in Nursing and Health Care, 6th Edition UNIT 5: POLICY AND POLITICS IN THE GOVERNMENT Alma Dixon Highly Recommended Chapters: Chapter 63: Contemporary Issues in Government Chapter 65: An Overview of Legislation and Regulation Chapter 66: Nursing Licensure and Regulation Chapter 73: The American Voter and the Electoral Process Suggested Chapters: Chapter 67: Regulating Industrial Chemicals to Protect the Environment and Human Health Chapter 72: Nursing and the Courts Optional Chapters: Chapter 64: How Government Works: What You Need to Know to Influence the Process Chapter 68: Lobbying Policymakers: Individual and Collective Strategies Chapter 69: Taking Action: An Insider’s View of Lobbying Chapter 70: Political Appointments Chapter 71: Taking Action: Influencing Policy as a Member of the San Francisco Health Commission Chapter 74: Taking Action: Anatomy of a Political Campaign Chapter 75: Taking Action: Nurses for Obama: My Advocacy and Experience on the Campaign Trail Chapter 76: Is There a Nurse in the House? The Nurses in the United States Congress Chapter 77: Taking Action: Nurse, Educator, and Legislator: My Journey to the Delaware General Assembly Chapter 78: Taking Action: Into the Rabbit Hole: My Journey to Service on a City Council Chapter 79: Taking Action: Truth or Dare: One Nurse’s Political Campaign Chapter 80: Political Activity: Different Rules for Government-Employed Nurses

UNIT OVERVIEW The unit begins with a detailed review of the passage of the Patient Protection and Affordable Care Act. The information is described within a framework that provides students with the opportunity to learn about the complex, often contentious processes that are involved in a major health care reform. It also discusses the functioning and relationship among the federal, state, and local levels of government and the influential role nursing can play in the process.

RELEVANCE FOR STUDENTS: As beginning practitioners and concerned citizens, students need the depth and breadth of knowledge to understand this major piece of legislation that will impact health care as they begin their careers. In addition, as students

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engage in practice, they need to understand the functioning of the federal, state, and local levels of government and how they may advocate for change. Finally, as they practice, they need to know the functioning of the Board of Nursing and the legal and judicial system.

LEARNING OBJECTIVES 1. Describe the interdependence of politics, including diverse perspectives, shared values, and the passage of health care reform.

2. Cite the relationship and functioning among the federal, state, and local levels of government and how nursing can have an influence.

3. Identify the nursing licensure and regulation functions of a Board of Nursing (BON).

4. Describe the legal and judicial system and the role of the courts in shaping policy.

5. Describe the electoral process and the importance of voting.

TEACHING STRATEGIES Writing Assignment Purpose: To have students explore the current status of health care reform.

Instructions: Have students access the Website http://www.healthcare.org/, select the state in which they will reside and seek employment, and answer the following questions: 1. What does the Website reveal about health insurance in the state?

2. What is listed about general health statistics of population in the state?

3. What is the state’s health ranking?

4. Does the ranking have any correlation to health insurance?

5. What are the health highlights?

6. What health statistics surprise you?

7. Would you be able to access a health insurance price quote? If yes, what guidelines are provided? If not, why not?

8. List the state legislator(s) that sit(s) on the health committee.

9. What is the state’s position on health care reform? What is/was the support for reform? Is the debate ongoing?

10. What do you anticipate will be the influence of health care reform on your practice in this state?

Evaluation Criteria You will be evaluated on your ability to research health insurance in the state you select and comprehensively answer the following questions: 1. What does the Website reveal about health insurance in the state?......10 points 2. What is listed about general health statistics of population in this state?...................................................5 points 3. What is the state’s health ranking?...........................................................5 points 4. Does the ranking have any correlation to the number of people reported to have health insurance?……………10 points 5. What are the highlights of health for the people in the state?................................................................5 points 6. What health statistics surprised you? 5 points 7. Would you be able to access a health insurance quote? If yes, what guidelines are provided? If not, why not?..................................................................10 points 8. Locate the state legislator(s) that sit(s) on the health committee…………..5 points Copyright © 2012 by Saunders, Inc., an affiliate of Elsevier Inc.

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9. What is their position on health care reform? What is/was the support for reform? Is the debate ongoing? …………………………………………..20 points 10. What do you anticipate will be the influence of health care reform on your practice in the state? …………………………………………………………………...25 points Writing Exercise Purpose: To provide the opportunity for students to analyze the political process by tracing a piece of legislation.

Instruction: Have students identify a bill that relates to health care, a social issue, or nursing practice, and answer the following questions: 1. State the legislation.

2. Who introduced/sponsored the bill?

3. Why did the person introduce it?

4. Where was it introduced?

5. Who helped to draft the legislation?

6. Was nursing involved?

7. Which committees were involved?

8. Was it authorized?

9. Was it appropriated?

10. Did it make it out of committee?

11. Was it enacted?

12. What is the impact on health care or nursing practice?

Evaluation Criteria You will be evaluated on your ability to identify a piece of legislation and answer the following questions: 1. State the legislation. ………………………………………..….10 points 2. Who introduced/sponsored the bill?………………………..….5 points 3. Why did the person introduce it?.........................................10 points 4. Where was it introduced?......................................................5 points 5. Who helped to draft the legislation?.....................................10 points 6. Was nursing involved?.........................................................10 points 7. Which committees were involved?........................................5 points 8. Was it authorized?............................................................... 5 points 9. Was it appropriated? …………………………………..……….5 points 10. Did it make it out of committee?.............................................5 points 11. Was it enacted?.......................................................................5 points 12. What is the impact on health care or nursing practice?........25 points Group Exercise Purpose: To provide students with the opportunity to observe a state Board of Nursing (BON) meeting and explore how it protects the welfare and safety of citizens and regulates the practice of nursing.

Instructions: Provide an opportunity for students to observe a state Board of Nursing (BON) meeting. Prepare for the meeting by having them gather the following information and hand in the written responses prior to the meeting:

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UNIT 5

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1.

2.

3.

4.

5.

6.

What is the structure and authority of the BON? What is the composition of the BON? What is the code of conduct as described in the Nurse Practice Act? What is the method of addressing complaints about individual nurses?

How is professional misconduct defined?

Is there a distinction between intentional misconduct and inevitable human error? If yes, how is it defined? If not, what policy change would you suggest?

7. What are the sanctions for misconduct?

8. What are the privacy and confidentiality provisions of the administrative statutes?

9. How do nurses remain in good standing?

Evaluation Criteria Written Assignment Prior to the BON meeting, you are required to submit the answers to the following: 1. What is the structure and authority of the BON?...........................................5 points 2. What is the composition of the BON?............................................................5 points 3. What is the code of conduct as described in the Nurse Practice Act? …………………...5 points 4. What is the method of addressing complaints about individual nurses? …...5 points 5. How is professional misconduct defined?.............................................5 points 6. Is there a distinction between intentional misconduct and inevitable human error? If yes, how is it defined? If not, what policy change would you suggest?..........10 points 7. What are the sanctions for misconduct?..........................................5 points 8. What are the privacy and confidentiality provisions of the administrative statutes?…

5 points 9. How do nurses remain in good standing?…………………………………5 points 10. Attendance at the BON Meeting……………………………………………..50 points Writing Exercise Purpose: To provide an opportunity for students to explore the position of a political candidate as it relates to a health care issue.

Instructions: Have students choose a health care issue that concerns them as a beginning nurse practitioner, and complete the following: 1. State the issue.

2. Identify a political candidate who shares your interest.

3. How might you support that candidate?

4. Write a letter to the candidate stating your support for his or her position.

Evaluation Criteria You will be evaluated on the following criteria: 1. Ability to identify a health care issue…………………………….20 points 2. Ability to identify a political candidate’s position………………..20 points 3. Ability to determine a method to demonstrate support of the candidate…25 points 4. Ability to write a thorough, concise letter that clearly states well-documented reasons for your support…………………………………………..35 points

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UNIT 5

5

Optional Exercise Writing Assignment Purpose: To provide the opportunity for students to select an area of interest in policy and politics in the government and apply the knowledge to their clinical practice or experience.

Instructions: Step 1: Student may select one of the following chapters: Chapter 69: Taking Action: An Insider’s View of Lobbying Chapter 71: Taking Action: Influencing Policy as a Member of the San Francisco Health Commission Chapter 74: Taking Action: Anatomy of a Political Campaign Chapter 75: Taking Action: Nurses for Obama: My Advocacy and Experience on the Campaign Trail Chapter 77: Taking Action: Nurse, Educator, and Legislator: My Journey to the Delaware General Assembly Chapter 78: Taking Action: Into the Rabbit Hole: My Journey to Service on a City Council Chapter 79: Taking Action: Truth or Dare: One Nurse’s Political Campaign Step 2: Complete the following questions: 1. Why did you select the chapter?

2. What did you learn about the role of the nurse as an activist?

3. What problems were encountered?

4. What might you have done differently?

5. How does it relate to your practice in the future?

Evaluation Criteria You will be evaluated on your ability to apply the knowledge from the chapters in Unit 5: Policy and Politics in the Government by answering the following questions: 1. Why did you select the chapter?…………..15 points 2. What did you learn about the role of the nurse as an activist?……25 points 3. What problems were encountered?…………………………… 15 points 4. What might have you done differently?....................................15 points 5. How does it relate to your practice in the future?.........30 points

Copyright © 2012 by Saunders, Inc., an affiliate of Elsevier Inc.

Mason: Policy & Politics in Nursing and Health Care, 6th Edition UNIT 6: POLICY AND POLITICS IN ASSOCIATIONS AND INTEREST GROUPS Alma Dixon Highly Recommended Chapters: Chapter 82: Current Issues in Nursing Associations Chapter 83: Professional Nursing Associations: Meeting Needs of Nurses and the Profession Suggested Chapters: Chapter 81: Interest Groups in Health Care Policy and Politics Chapter 86: Coalitions: A Powerful Political Strategy Chapter 90: The Politics of the Pharmaceutical Industry Optional Chapters: Chapter 84: Taking Action: The Center to Champion Nursing in America: Mobilizing Consumers and Other Stakeholders Chapter 85: Taking Action: The Raise the Voice Campaign: Nurse-Led Innovations Changing Public Policy Chapter 87: Taking Action: A Rough Road in Texas: Advanced Practice Nurses Build a Strong Coalition Chapter 88: Taking Action: The National Coalition for Lesbian, Gay, Bisexual, and Transgender Health Chapter 89: Taking Action: The Virginia Nursing Kitchen Cabinet UNIT OVERVIEW The unit discusses the role of nursing associations, including the problems associated with membership and involvement in collective bargaining. A detailed review of the structure and functioning of nursing associations provides the criteria to direct a student’s choice after graduation.

RELEVANCE FOR STUDENTS: As future practitioners who will belong to the profession, students need to understand the role of nursing associations, including providing continuing education credits, being a place to volunteer in an area of interest, and supporting a collective voice to advance the profession and health care.

LEARNING OBJECTIVES 1. Explain the need for nursing associations.

2. Review the impact of collective bargaining on membership and revenues.

3. Define the benefits of organizational engagement in nursing associations.

4. Review the components of successful coalition building, maintenance, and success.

TEACHING STRATEGIES

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Writing Assignment Purpose: To provide the opportunity for students to reflect on the need for nursing associations.

Instructions: Have students answer the following: 1. Is there a need for professional organizations? If yes, why? If no, why not?

2. Should there be one organization that is the voice for nursing? If yes, why? If no, why not?

Grading Criteria You will be graded on the following criteria: 1. Your ability to state a position and explain the reason for the choice….30 points 2. Your ability to demonstrate an understanding of the role of professional organizations…………………………………………………………………40 points 3. Your ability to organize your thoughts and complete a well-written, clear, and readable paper…………………………………………………………....…30 points Group Exercise Purpose: To provide the opportunity for students to complete an in-depth analysis of an association and the process of recruitment and engagement of other students.

Instructions: Have students complete the following: Step 1: Select a national organization with a student nurse component.

Step 2: Begin a campaign to recruit nursing students to join the organization. Prepare recruitment documents that include the following: 1. History of the organization 2. Mission of the organization 3. Who is eligible to join 4. Benefits of membership 5. Continuing education opportunities 6. Advocacy efforts Step 3: Give your campaign a name.

Step 4: Create advertising to attract potential members.

Evaluation Criteria You will be evaluated on the following criteria: 1. Ability to select an organization………………………………….20 points 2. Research completed about the organization…………………….25 points 3. Creativity and comprehensiveness of your campaign………….35 points 4. Preparation of recruitment materials…………………………………..20 points Writing Assignment Purpose: To provide students with tools to select a nursing organization.

Instructions: Have students focus on the theme “Which organization will I join and why”? and then complete the following: 1. Select a nursing organization.

2. What is the organizational structure?

3. What is the organization’s purpose, mission statement, bylaws, and policies?

4. What are the committees/task forces and ways to be involved (volunteer)?

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5. Do they match your professional and personal needs?

6. Are there opportunities for members to be heard?

7. Can you attend a local or national meeting to explore potential membership?

8. Are you able to speak with current members?

9. What are the products and services?

10. Will you join the organization? If yes, why? If no, why not?

Evaluation Criteria After you select a nursing organization, you will be evaluated on your ability to write a wellresearched paper that answers the following: 1. What is the organizational structure? ………………………………………10 points 2. What is the organization’s purpose, mission statement, bylaws, and policies?...10 points 3. What are the committees/task forces and ways to be involved (volunteer)?...10 points 4. Do they match your professional and personal needs? …10 points 5. Are there opportunities for members to be heard? ……….10 points 6. Can you attend a local or national meeting to explore potential membership?....

10 points 7. Are you able to speak with current members?...10 points 8. What are the products and services?....10 points 9. Will you join the organization? If yes, why? If no, why not?.................20 points Optional Exercise Writing Assignment Purpose: To provide the opportunity for students to select an area of personal interest in policy and politics in associations and interest groups.

Instructions: Step 1: Student may select one of the following chapters: Chapter 84: Taking Action: The Center to Champion Nursing in America: Mobilizing Consumers and Other Stakeholders Chapter 85: Taking Action: The Raise the Voice Campaign: Nurse-Led Innovations Changing Public Policy Chapter 87: Taking Action: A Rough Road in Texas: Advanced Practice Nurses Build a Strong Coalition Chapter 88: Taking Action: The National Coalition for Lesbian, Gay, Bisexual, and Transgender Health Chapter 89: Taking Action: The Nursing Kitchen Cabinet: The Virginia Nursing Coalition Step 2: Answer the following questions: 1. Why did you select the chapter?

2. What did you learn about the role of the nurse as an activist?

3. What problems were encountered?

4. What might have you done differently?

5. What did you learn from the chapter about politics in associations and interest groups?

6. What will you apply to your clinical practice?

Evaluation Criteria

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You will be evaluated on your ability to apply the knowledge from the chapters in Unit 6: Policy and Politics in Associations and Interest Groups by answering the following questions: 1. Why did you select the chapter?…………………………………….………..15 points 2. What did you learn about the role of the nurse as an activist?………...…..15 points 3. What problems were encountered?………………………………………..…15 points 4. What might have you done differently?.....................................................15 points 5. What did you learn from the chapter about politics in associations and interest groups?……………………………………………………………………20 points 6. What will you apply to your clinical practice?……………………………20 points

Copyright © 2012 by Saunders, Inc., an affiliate of Elsevier Inc.

Mason: Policy & Politics in Nursing and Health Care, 6th Edition UNIT 7: POLICY AND POLITICS IN THE COMMUNITY Alma Dixon Highly Recommended Chapters: Chapter 91: Where Policy Hits the Pavement: Contemporary Issues in Communities Chapter 92: An Introduction to Community Activism Chapter 104: Human Trafficking: The Need for Nursing Advocacy Suggested Chapters: Chapter 101: Nursing in the International Community: A Broader View of Nursing Issues Chapter 103: Emerging and Reemerging Infectious Disease: A Global Challenge Optional Chapters: Chapter 93: Taking Action: From Sewage Problems to the Statehouse: My Life as an Elected Official Chapter 94: Taking Action: Community Advocacy in Pennsylvania: How I Worked to Make My Community Healthier Chapter 95: Taking Action: A Nurse Practitioner’s Advocacy Efforts in Nevada Chapter 96: Taking Action: One Nurse’s Fight Against Gang Violence in California Chapter 97: Taking Action: The Canary Coalition for Clean Air in North Carolina’s Smoky Mountains Chapter 98: Taking Action: The Nightingales Take on Big Tobacco Chapter 99: Lactivism: Breastfeeding Advocacy in the United States Chapter 100: Postpartum Depression: The Convergence of Media Coverage and Community Activism to Influence Health Policy Chapter 102: Taking Action: Ugandan Nurses Leading Health Policy Change UNIT OVERVIEW This unit focuses on strategies to advocate for the health of communities and the role of the nurse as a community activist. It frames the discussion that will enable students to learn the difference between community activism and community service. Contemporary public health issues such as emerging infectious diseases and human trafficking are presented as issues with current relevance to practice in all clinical settings.

RELEVANCE FOR STUDENTS: As future baccalaureate prepared nurses, students need to understand the importance of the physical and socioeconomic environments in determining the health care and nursing care needs of communities in which their patients reside. Regardless of the choice of clinical site where they practice, students need to know that public health issues are reflective of the times and will have an impact on patient care.

Therefore, they must remain vigilant about issues for which they can be advocates and champions for those who do not have a voice.

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LEARNING OBJECTIVES 1. Review the nature of communities.

2. Define the components of a health community.

3. Describe the social determinants of health and the impact on health and quality of life.

4. Distinguish the difference between the nurse as a community activist as opposed to the nurse as a community servant.

5. Examine the threat to public health from emerging and reemerging infectious diseases.

6. Expose human trafficking as a contemporary public health problem with global and domestic implications.

TEACHING STRATEGIES Individual Exercise Purpose: To provide an opportunity for students to analyze the health issues of a community and suggest a policy to improve the health status of its citizens.

Instructions: Have students go to http://www.countyhealthrankings.org/ and select a county and a state (this may be the county/state in which you reside, attend school, or plan to live and work).

1. What are the health outcomes in the County Health Rankings for the area you selected as measured by mortality and morbidity?

2. What are the health factors in the County Health Rankings represented by the 4 types of health behaviors (4 factors are health behaviors, clinical care, social and economic, and physical environment)?

3. Select one area in need of improvement.

4. What resources are available to address the problem?

5. What policy might you suggest to improve the ranking in that area?

Evaluation Criteria You will be evaluated on your ability to analyze the health issues of the community you select and the policy you suggest to improve the health status of its citizens.

1. What are the health outcomes in the County Health Rankings for the area you selected as measured by mortality and morbidity?……………………15 points 2. What are the health factors in the County Health Rankings represented by the 4 types of health behaviors (4 factors are health behaviors, clinical care, social and economic, and physical environment)? …………………… 20 points 3. Select one area in need of improvement.………………………………..10 points 4. What resources are available to address the problem?........................25 points 5. What policy might you suggest to improve the ranking in that area?...30 points Writing Activity Purpose: To provide students with the opportunity to examine an emerging infectious disease they may encounter and suggest a public health policy to address an outbreak of this disease.

Instructions: Have students select an emerging infectious disease that is of concern in their community and answer the following questions:

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Name the disease, its cause, and how it is transmitted.

What is the surveillance process and reporting mechanism?

Are all areas of the community equally at risk?

What are the public health policies pertaining to the disease?

How is the community involved in prevention, marketing information, and teaching?

If you were employed in an acute care setting, what are the implications for practice?

What changes would you suggest in public health policy or procedure to address the issue?

Evaluated Criteria You will be evaluated on your ability to identify an emerging infectious disease in the community you select and the implications for policy that you identify.

1. Name the disease, its cause, and how it is transmitted. ……………………………………..10 points 2. What is the surveillance process and reporting mechanism?.......10 points 3. Are all areas of the community equally at risk?...............................10 points 4. What are the public health policies pertaining to the disease?........10 points 5. How is the community involved in prevention, marketing information teaching?......................................................15 points 6. If you were employed in an acute care setting, what are the implications for practice?...20 points 7. What changes would you suggest in public health policy or procedure?...25 points Group Exercise Purpose: To provide an exercise in community activism using the college campus.

Instructions: The Power and Control Wheel is widely recognized as a visual presentation of the tactics used in an abusive relationship. It was developed as a result of a community wide decision to end violence against women in Duluth, Minnesota. Students may have already utilized the Wheel in other classes or in a clinical facility.

Divide the class into groups to accomplish the following tasks: Task 1: Go the Website theduluthmodel.org.

What steps were used to organize the community in Duluth?

Who were the stakeholders?

What was the underlying belief system?

What strategies were employed?

How was the Power and Control Wheel developed?

Task 2: Collect data on violence against women on college campuses. Possible sources of information are http://www.ovw.usdoj.gov/campus-institute.htm and http://www.feministcampus.org/.

Collect data on violence against women on the campus including the number of offenses, types of offenses, demographic data on the victims.

Task 3: Using the process from the Duluth experience in Task 1, answer the following questions:

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What steps would you use to organize the community?

Who are the stakeholders?

What is the underlying belief system?

What strategies would you suggest to end violence against women on the campus?

What policies will you suggest?

Evaluation Criteria All students in the group are expected to participate in each task; therefore, each student in the group will receive the same group evaluation.

Task 1: The ability to demonstrate an understanding of organizing a community to take action using the Duluth, Minnesota, experience to end violence against women.

Answer the following questions: 1. What steps were used to organize the community in Duluth?......................30 points 2. Who were the stakeholders?.........................................................................10 points 3. What was the underlying belief system?.......................................................10 points 4. What strategies were employed?..................................................................25 points 5. How was the Power and Control Wheel developed? ………………………...25 points Task 2: The ability to develop a community project using the Duluth, Minnesota, experience to end violence against women 1. What steps would you use to organize the community?………………….30 points 2. Who are the stakeholders?......................................................................10 points 3. What is the underlying belief system?....................................................10 points 4. What strategies would you suggest to end violence against women on the campus?..................................................................................................25 points 5. What policies will you suggest? ……………………………………………25 points Group Exercise Purpose: To explore a hidden or invisible public health problem Instruction: Students are to engage in a panel discussion on “Human Trafficking: The Need for Nursing Advocacy.” In preparation, they are expected to thoroughly research the issue.

Students should choose a spokesperson for the topic, but all students in the group are expected to be prepared to join the discussion. The five issues are as follows; each group selects one: 1. The scope of the problem of human trafficking from a global perspective 2. Human trafficking as a domestic issue 3. Human trafficking as a health issue 4. State how nurses can advocate for the victims of human trafficking.

Evaluation Criteria All students in the group are expected to be prepared to join in the discussion of the panel; therefore you are expected to thoroughly research the issue. Each student in the group will receive the same group evaluation. You will be judged on the following: Quality of the preparation including the background of the issue………10 points Quality of the research presented to clarify the issue……………………20 points

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Ability to present the issue in a clear, concise manner…………………20 points Ability to suggest policy issues that are related to the topic chosen…….20 points Ability to suggest a community intervention……………………………30 points Optional Exercise Writing Activity Purpose: To provide the opportunity for students to select an area of personal interest in policy and politics and apply it to the community.

Instructions Step 1: Students may select one of the following chapters: Chapter 93: Taking Action: From Sewage Problems to the Statehouse: My Life as an Elected Official Chapter 94: Taking Action: Community Advocacy in Pennsylvania: How I Worked to Make My Community Healthier Chapter 95: Taking Action: A Nurse Practitioner’s Advocacy Efforts in Nevada Chapter 96: Taking Action: One Nurse’s Fight Against Gang Violence in California Chapter 97: Taking Action: The Canary Coalition for Clean Air in North Carolina’s Smoky Mountains Chapter 98: Taking Action: The Nightingales Take on Big Tobacco Chapter 99: Lactivism: Breastfeeding Advocacy in the United States Chapter 100: Postpartum Depression: The Convergence of Media Coverage and Community Activism to Influence Health Policy Step 2: Answer the following questions: 1. Why did you select the chapter?

2. What did you learn about the role of the nurse as an activist?

3. What problems were encountered?

4. What might have you done differently if it was your community?

5. What did you learn from the chapter about politics in the community?

6. Would you suggest another policy as an outcome? If yes, what would it be? If no, why not?

Evaluation Criteria You will be evaluated on your ability to apply the knowledge from the chapters in Unit 7: Policy and Politics in the Community by answering the following questions: 1. Why did you select the chapter?…………………………………15 points 2. What did you learn about the role of the nurse as an activist?…..15 points 3. What problems were encountered?…………………………………15 points 4. What might have you done differently if it was your community?......15 points 5. What did you learn from the chapter about politics in the community? …20 points 6. Would you suggest another policy as an outcome? If yes, what would it be? If no, why not?....20 points

Copyright © 2012 by Saunders, Inc., an affiliate of Elsevier Inc.