Discussion: Agenda Setting NURS 8100

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Discussion: Agenda Setting NURS 8100

RE: Discussion – Week 3

Agenda Setting on Patient Safety

Agenda setting is a critical component of the public policy process. The agenda is the set of issues that policymakers or others with influence (direct or indirect) on decision-making consider important at any given time (Kingdon, 2003). Healthcare organizations have recently become interested in the safety culture. Given the significance of nurses’ roles in patient safety, their knowledge and experiences with the challenges that influence patient safety culture can aid in the development and implementation of better strategies. The clinical practice issues that I believe should be on the systematic agenda of my organization will be to investigate nurses’ experiences with the challenges influencing the implementation and integration of safety culture in healthcare (Farokhzadian, Dehghan Nayeri, & Borhani, 2018). Nurses and nursing management are the stakeholders who would be interested in this clinical practice issue. Although patient safety is a new and emerging phenomenon, historical evidence suggests that concerns about patient safety existed long before modern healthcare. Florence Nightingale stated more than 150 years ago that “the very first requirement in a hospital is to do no harm to patients” (Friesen, Farquhar, & Hughes, 2016). In 2001, the Institute of Medicine (IOM) issued a report titled “Crossing the Quality Chasm: A New Health System for the Twenty-First Century.” The IOM emphasized the importance of healthcare safety and the need for patients to be free of danger or risk caused by the healthcare system (Farokhzadian, Dehghan Nayeri, & Borhani, 2018). Modern advances and the complexity of healthcare have resulted in serious deficiencies in care quality and patient safety. The high prevalence of clinical risks and safety incidents has increased healthcare systems’ concerns and challenges (Farokhzadian, Nayeri, & Borhani 2015). Although estimates of the size of the problem are imprecise, millions of people are likely to suffer from disabling injuries or death as a result of clinical risk and safety incidents. It is estimated that one out of every ten patients in developed-country hospitals is harmed while receiving unsafe care. Furthermore, the risk of damage is far greater in developing countries than in developed countries. For example, in some developing countries, the risk of healthcare-associated infection is twenty times higher than in developed countries (Farokhzadian, Dehghan Nayeri, & Borhani, 2018).

Patient Safety Indicators will be used by me as a patient safety advocate. This will include data on the quality of inpatient care, as well as information on avoidable complications and adverse events. After an extensive literature review, analysis of the International Classification of Diseases, Ninth Revision, Clinical Modification medical coding system codes (e.g., rates of death, pressure injury, surgical infection, retained surgical items), expert panel review, risk adjustment, and empirical analyses, Patient Safety Indicators were identified and developed (Agency for Healthcare Research and Quality, 2016). Through routinely gathered point prevalence and administrative data, Patient Safety Indicators assist in the detection of probable adverse events (e.g., inpatient problems) that require further investigation. PSIs have been used by clinical researchers to better understand adverse occurrences and highlight potential areas for practice improvement in the health-care system. Pressure injury prevention, clinical handover, pharmaceutical safety, falls prevention, nutrition services, and venous thromboembolism prophylaxis are the six areas where the PSIs will be concentrated in the facility. Research and quality improvement (QI) efforts in the hospital usually require collaboration across multiple systems and disciplines. Historically, the PSIs have been driven by an emphasis on quality improvement. The desire to engage clinical researchers with experience in the creation and implementation of practice-based interventions has grown as a result of the need to establish robust evidence-based interventions that underpin QI projects and have long-term impacts.

Discussion: Agenda Setting NURS 8100

References

Agency for Healthcare Research and Quality. (2016). Patient Safety Indicators overview. http://www.qualityindicators.ahrq.gov/modules/psi_overview.aspx

Farokhzadian, J., Dehghan Nayeri, N., & Borhani, F. (2018). The long way ahead to achieve an effective patient safety culture: challenges perceived by nurses. BMC health services research, 18(1), 654. https://doi.org/10.1186/s12913-018-3467-1

Farokhzadian J, Nayeri ND, Borhani F. (2015). Rocky milieu: challenges of effective integration of clinical risk management into hospitals in Iran. Int J Qual Stud Health Well-being; 10(1):27040. doi: 10.3402/qhw.v10.27040

Friesen MA, Farquhar MB, & Hughes R. (2016). The nurse’s role in promoting a culture of patient safety: Center for American Nurses. ana.nursingworld.org/mods/archive/mod780/cerole full.htm

Gillespie, B. M. (2016). Setting a Quality Improvement and Research Agenda for Patient Safety in a Tertiary Hospital in Australia: Global perspectives. AORN Journal, 103(6), 632-635. http://dx.doi.org/10.1016/j.aorn.2016.04.007

Kingdon, J. (2003). Agendas, Alternatives, and Public Policies (3a. Ed.) New York, NY: Harper Collins.

Discussion: Agenda Setting

A key aspect of the policy process is agenda setting. How do topics get on that agenda?
Agenda setting requires the support of stakeholders to move the issue forward. In this
week's media presentation, Dr. Kathleen White outlines the policy process and
discusses how to move issues into the policy arena through agenda setting. The
ultimate goal is to gain the attention of leadership whether at the organizational, local,
state, national, or international level.
To get ready: Examine this week’s media presentation, paying special attention to the ideas offered by Dr. White and Dr. Stanley on agenda setting and stakeholder identification.
 Consider clinical practice challenges that you believe should be on your organization’s systematic agenda.
Who are the potential stakeholders in this clinical practice issue?
By Day 3
Post a unified response that addresses the following points:
 Identify the clinical practice issue you want to see on your organization’s systematic agenda in the first line of your posting.
What techniques would you employ to inform and persuade stakeholders of the significance of your identified clinical practice issue?
Read a few of your coworkers’ postings.
By Day 6
Respond to at least two of your coworkers with further informing strategies.

Discussion Agenda Setting NURS 8100

and persuading stakeholders. Include additional research evidence that supports the
importance of their identified clinical practice issue.
Note: Please see the Syllabus and Discussion Rubric for formal Discussion question
posting and response evaluation criteria.
Return to this Discussion in a few days to read the responses to your initial posting.
Note what you learned and/or any insights you gained as a result of the comments
made by your colleagues.
Be sure to support your work with specific citations from this week’s Learning
Resources and any additional sources.
Submission and Grading Information
Grading Criteria
To access your rubric:
Week 3 Discussion Rubric

Post by Day 3 and Respond by Day 6
To participate in this Discussion:
Week 3 Discussion

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Learning Resources

Note: To access this week’s required library resources, please click on the link to the
Course Readings List, found in the Course Materials section of your Syllabus.
Required Readings
Hyder, A., Syed, S., Puvanachandra, P., Bloom, G., Sundaram, S., Mahmood, S., …
Peters, D. (2010). Stakeholder analysis for health research: case studies from low- and
middle-income countries. Public Health, 124(3), 159–166.
Note: You will access this article from the Walden Library databases.

This study demonstrates how the engagement of stakeholders in research and policy
making can assist in the successful implementation of policy proposals. The authors
propose that by engaging stakeholders, researchers and policy makers are provided
with multiple perspectives on proposed policies, which can lead to greater success with
policy adoption and implementation.
Lavis, J. N., Permanand, G., Oxman, A. D., Lewin, S., & Fretheim, A. (2009).
SUPPORT Tools for evidence-informed health Policymaking (STP) 13: Preparing and
using policy briefs to support evidence-informed policymaking. Health Research Policy
& Systems, 71–79. doi: 10.1186/1478-4505-7-S1-S13
Note: You will access this article from the Walden Library databases.

The purpose of a policy brief is to communicate an issue clearly and definitively to policy
makers. The authors of this article propose an outline for policy briefs and also stress
the importance of using research when creating a policy brief.

Lowery, B. (2009). Obesity, bariatric nursing, and the policy process: The connecting
points for patient advocacy. Bariatric Nursing & Surgical Patient Care, 4(2), 133–138.
Note: You will access this article from the Walden Library databases.

This article provides an example of nurse involvement in policy making by examining a
bariatric nursing issue. The author stresses that nurses, in their patient-advocacy role,
have a responsibility to be involved in the health care policy process.
Moore, K. (2006). How can basic research on children and families be useful for the
policy process? Merrill-Palmer Quarterly, 52(2), 365–375.
Note: You will access this article from the Walden Library databases.
Institute of Medicine. (2010). The future of nursing: Leading change, advancing health:
Report recommendations. Retrieved
from http://www.nationalacademies.org/hmd/~/media/Files/Report%20Files/2010/The-
Future-of-Nursing/Future%20of%20Nursing%202010%20Recommendations.pdf

Introduced in Week 2, this IOM report highlights four key recommendations in its
proposal for the future directions of the nursing profession. These recommendations
focus on nursing practice, education and training, partnerships with other healthcare
professionals, and workforce planning and policymaking.
National Center for Policy Analysis (2010). Ideas changing the world: Free-market
health care policy. Retrieved from http://www.ncpathinktank.org/healthcare

The NCPA is a nonprofit, nonpartisan organization that promotes private sector
solutions to public policy issues.
Required Media
Laureate Education, Inc. (Executive Producer). (2011). Healthcare policy and advocacy:
Agenda setting and the policy process. Baltimore: Author.

Note: The approximate length of this media piece is 17 minutes.

Dr. Kathleen White and Dr. Joan Stanley share their insights into agenda setting and
how issues are moved forward into the policy process.

Accessible player
Optional Resources
Barnes, M., Hanson, C., Novilla, L., Meacham, A., McIntyre, E., & Erickson, B. (2008).
Analysis of media agenda setting during and after Hurricane Katrina: Implications for
emergency preparedness, disaster response, and disaster policy. American Journal of
Public Health, 98(4), 604–610.
Jennings, C. (2002). The power of the policy brief. Policy, Politics & Nursing Practice,
3(3), 261–263. doi: 10.1177/152715440200300310

Neumann, P. J., Palmer, J. A., Daniels, N., Quigley, K., Gold, M. R., & Chao, S. (2008).
A strategic plan for integrating cost-effectiveness analysis into the US health care
system. American Journal of Managed Care, 14(4), 185-188.
Plan, Policy, Procedure Relationship Diagram. (n.d.). Retrieved from
http://www.informationsecurityintel.com/docs/Fig.%204.3.pdf

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