NURS 6050 Evidence Base in Design 

Sample Answer for NURS 6050 Evidence Base in Design  Included After Question

By Day 3 of Week 7

Post a description of the health policy you selected and a brief background for the problem or issue being addressed. Which social determinant most affects this policy? Explain whether you believe there is an evidence base to support the proposed policy and explain why. Be specific and provide examples.

By Day 6 of Week 7

Respond to at least two of your colleagues* on two different days by either supporting or respectfully challenging their explanation on whether there is an evidence base to support the proposed health policy they described.

A Sample Answer For the Assignment: NURS 6050 Evidence Base in Design 

Title: NURS 6050 Evidence Base in Design 

The health policy selected is the Health Equity and Accountability Act (HEAA) of 2020. A brief background about this act is (congress.gov, 2020) “this bill directs the Department of health, and human services (DHHS) and others to undertake efforts to reduce disparities”. These are disparities that exist particularly in health care.

It has been reported since 2007, HEAA has been introduced by Congressional Tri-Caucus, comprised of the Congressional Asian Pacific American Caucus (CAPAC), the Congressional Black Caucus (CBC), and the Congressional Hispanic Caucus (CHC).  

The development of HEAA builds on the gains made under the Affordable Care Act (ACA) and lays out a vision of additional investments Congress should make to respond to the policy threats against the health and well-being of the underserved communities, address health disparities and ensure access to quality, affordable health care for all.

In (The health equity and accountability act, n.d.) “Over 300 racial, and health equity organizations, researchers, provider groups, and community-based organizations have contributed to the development of HEAA since its inception”.

I believe there is evidence to support the proposed policy because being a woman of color working in the behavioral health emergency department within a large metropolitan health system, and as a board certified psychiatric, and mental health registered nurse, I have experienced the disparities when providing care to people of color, health care professionals are often dismissive, and or mental health patients are provided less resources than white people. Therefore, the proposed HEAA is needed to overturn systemic disparities in mental health care.

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Supporters of HEAA point to statistics that demonstrate the current lack of health equity. HEAA specifically addresses multiple issues such as (Walden University, 2021) “culturally, and linguistically appropriate care, health workforce diversity, and mental health” to mention a few.

For instance, expanding mental, and behavioral services targeting low-income, communities of color because “mental health research has found that while mental health illness is more or less equally prevalent in all groups, members of minority groups enter treatment later and have worse outcomes” (Walden University, 2021). This policy affects me personally and professionally and as a result I am a strong supporter of the health equity and accountability act.

References

The Health Equity and accountability act – unidosus.org. (n.d.). Retrieved January 9, 2022, from https://www.unidosus.org/wp-content/uploads/2021/07/unidosus_heaafactsheet_10819.pdf

H.R.6637 – 116th Congress (2019-2020): Health Equity and … (n.d.). Retrieved January 9, 2022, from https://www.congress.gov/bill/116th-congress/house-bill/6637

Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide. Jones & Bartlett Learning.

Walden University. (2021, November 4). The-facts-behind-the-health-equity-and-accountability-act-HEAA. Walden University. Retrieved January 9, 2022, from https://www.waldenu.edu/online-doctoral-programs/phd-in-public-health/resource/the-facts-behind-the-health-equity-and-accountability-act-heaa

A Sample Answer 2 For the Assignment: NURS 6050 Evidence Base in Design 

Title: NURS 6050 Evidence Base in Design 

This legislation caught my eye and it is unfortunate that we still have to deal with so much disparities at this time.  The COVID-19 pandemic has not only exposed the glaring and ever-present structural racism in the United States, but it has also exposed racial/ethnic tensions, resulting to national protests for racial and social justice (Norris & Gonzalez, 2020).

NURS 6050 Evidence Base in Design 
NURS 6050 Evidence Base in Design 

The Health Equity and Accountability Act (HEEA) provides an opportunity to address this long-persisting disparities that have hindered progress towards achieving this goal of Health Equity.  Looking at the provisions, this should correct deficiencies in data collection and reporting, advocate for culturally appropriate health care, improve health workforce diversity, improve health care access, address mental health and take many more actions to improve health equity (Congress.gov, n.d.).  

In addition, according to Keith & Gonzalez (2020), while working on structural inequalities, it is important to improve people’s living and working environments so that they can reach their maximum potential.  The United States is known for diversity but serious structural inequalities persist which has been more exposed with the current health situation in the country

References

Congress.gov. (n.d) retrieved on 1/11/2022 from https://www.congress.gov/bill/116th-congress/house-bill/8200/text

Keith Norris, & Cynthia Gonzalez. (2020). COVID-19, health disparities and the US election. EClinicalMedicine, 28(100617-). https://doi.org/10.1016/j.eclinm.2020.100617

A Sample Answer 3 For the Assignment: NURS 6050 Evidence Base in Design 

Title: NURS 6050 Evidence Base in Design 

Thank you for talking about this as a discussion. I also work at what the world considers a top 5 hospital in the Nation which is also located in the inner city.  I have witnessed disparities in the health care of people of color. And as you stated “health care professionals are dismissive” to care of people of color. I have also witnessed social work rounding groups offer fewer resources made available to people of color vs other cultural groups. Often, I do have to advocate for people of color and other minority groups to help connect the lines of education if there are health care disparities involved. The Henrietta Lacks Enhancing Cancer Research Act is also a bill in which I support and feel there is evidence to support this act. The family of Henrietta Lacks is still fighting presently for compensation due to the family for which the family feel samples were used without permission of the patient. This bill requires the Government Accountability Office to complete a study reviewing how federal agencies address barriers to participation in federally funded cancer clinical trials by individuals from underrepresented populations and provide recommendations for addressing such barriers. Here is a link below to the bill.

Congress. Gov (n.d.). Henrietta Lacks Enhancing Cancer Research Act.

https://www.congress.gov/bill/116th-congress/house-bill/1966

It is very unfortunate that even with the current advancements in healthcare that disparities in health status still exist. I support the Health Equity and Accountability act. Particularly the expansion of mental health services. There is a degree of distrust in the medical community amongst African Americans partially due to historical reasons. A study done at the George Warren Brown School of Social Work suggested that 56-74% of African American men who have experienced trauma have an unmet need for mental health services. (Motley & Banks, 2018). This shows the need for expansion of mental health services. The HEAA also coincides with the president’s agenda to “reduce health disparities in all healthcare programs” and “Provide additional funding to expand access to culturally competent care.” (Building Back Better, 2021). The current administration recognizes a need to decrease disparities amongst impoverished communities, and I support it.

References

Building back better [PDF]. (2021). https://www.govinfo.gov/content/pkg/BUDGET-2022-BUD/pdf/BUDGET-2022-BUD-3.pdf Motley, R., & Banks, A. (2018). Black males, trauma, and mental health service use: a systematic review. Perspectives on social work : the journal of the doctoral students of the University of Houston Graduate School of Social Work14(1), 4–

A Sample Answer 4 For the Assignment: NURS 6050 Evidence Base in Design 

Title: NURS 6050 Evidence Base in Design 

Quality and affordable healthcare is a major concern for all Americans. Healthcare is a multifaceted issue involving cost, accessibility, safety and quality. Even though many healthcare bills are introduced into the U.S Congress, few receive the necessary support required to enact them into law. One of the pending healthcare bills in Congress is the Lower Health Care Costs Act of 2019. Senators Lamar Alexander and Patty Murray sponsored this bill. If enacted, it will lower healthcare costs. This bill aims to make changes related to healthcare costs, services and coverage. It will require health insurance providers to make certain information such as out-of-pocket spending accessible to beneficiaries through technology such as mobile applications, among other provisions to reduce healthcare costs (Congress.gov, 2019).

This bill will aim to reduce out of pocket spending. This bill will eliminate surprise medical bills. Out-of-network charges expose patients to medical bills that they did not expect. In the last two years, one out of five insured adults has had unexpected surprise medical bills (Pollitz et al., 2020). This bill will aim to protect consumers from these out-of-network provider charges. This bill will create more transparency on healthcare services. Healthcare practitioners will be mandated to give their patients a list of services they received upon discharge and bill for such services within forty-five days (Congress.gov, 2019). This bill will address drug price issues. There has been a significant increase in drug prices in the United States. Approximately 25% of Americans find it hard to afford prescription medications due to high out-of-pocket spending (Rajkumar, 2020). This shows the high cost of prescription medications in the United States. This is because manufacturers keep generic drugs off the market. This bill will change requirements to expedite the production of biosimilar and generic drugs.

References

Congress.gov. (2019, July 8). S.1895 – 116th Congress (2019-2020): Lower Health Care Costs Act. Congress.gov | Library of Congress. https://www.congress.gov/bill/116th-congress/senate-bill/1895

Pollitz, K., Lopes, L., Kearney, A., Rae, M., Cox, C., Fehr, R., & Rousseau, D. (2020). US statistics on surprise medical billing. JAMA323(6), 498.  

Rajkumar, S. V. (2020). The high cost of prescription drugs: causes and solutions. Blood Cancer Journal10(6), 1-5.

A Sample Answer 5 For the Assignment: NURS 6050 Evidence Base in Design 

Title: NURS 6050 Evidence Base in Design 

Evidence to Support Good Samaritan Health Professionals Act of 2021

The healthcare policy selected to review is the Good Samaritan Health Professionals Act of 2021. This proposed policy aims to decrease the liability of healthcare professionals who volunteer services during a declared disaster (Congress.gov. n.d.). This liability protection would only apply under specific circumstances. The healthcare provider would be protected as long as they are practicing within their scope of practice, as a volunteer, during a declared emergency, and practicing in good faith. The protection will not apply if the healthcare worker causes harm willfully or is practicing under the influence of drugs and/or alcohol. It is important to note that this is for a volunteer who is providing services without any compensation. The Good Samaritan Health Professionals Act of 2021 is a policy that has been introduced to the House.

There is an evidence base to support the proposed policy of Good Samaritan Health Professionals Act of 2021. According to Medical Professional Liability Association (2021), the policies that are already in place are “ambiguous and inconsistent” and may even deter medical professionals from volunteering services during a disaster. In times of disaster (such as the current COVID crisis), it is imperative for healthcare workers to feel safe from lawsuit and liability when abiding by their scope of practice. Milstead & Short (2019) describe how “policies reflect public opinion as well as evidence-based data (p. 90).”  The Good Samaritan Health Professionals Act of 2021 would be in the interest of public opinion as disasters can affect anyone at any given time. Hoffman, Goodman, & Stier (2009) explain how healthcare volunteers could still be in danger of liability because of primary job payment and may not be covered depending on the location of practice. They also point out how healthcare providers may be deterred from volunteering in an emergency because of unclear guidance regarding their liability. The Good Samaritan Health Professionals Act of 2021 can be backed by evidence-based data and also support from healthcare workers who would like to volunteer in emergency but need clearer liability protection.

References

Congress.gov. (n.d.). Text: H.R.5239 — 117th Congress (2021-2022). Retrieved

January 10, 2022 from https://www.congress.gov/bill/117th-congress/house-bill/5239/text?q=%7B%22search%22%3A%5B%22healthcare+policies%22%2C%22healthcare%22%2C%22policies%22%5D%7D&r=19&s=8

Hoffman, S., Goodman, R. A., & Stier, D. D. (2009). Law, Liability, and Public Health

Emergencies. Disaster Medicine and Public Health Preparedness3(2), 117–125.

Medical Professional Liability Association. (2021). Good Samaritan Health Professionals

Act Would Offer Protections for Medical Volunteers and Preserve Patient Access to Care. Retrieved on January 10, 2022 from https://www.mplassociation.org/Web/Resources/News/Good_Samaritan_Health_Professionals_Act_Would_Offer_Protections_for_Medical_Volunteers.aspx

Milstead, J.A., & Short, N.M. (2019). Health Policy and politics: A nurse’s guide (6th ed).

Burlington, MA: Jones & Bartlett Learning

A Sample Answer 6 For the Assignment: NURS 6050 Evidence Base in Design 

Title: NURS 6050 Evidence Base in Design 

Health Care Provider Protection Act

This bill was introduced under H.R 8094 titled Dr. Lorna Breen Health Care Provider  Protection Act “to address behavioral health and well-being among health care professionals” (Congress.gov, n.d).

This bill creates a number of grants programs and mandates the Department of Health and Human Services (HHS) to take steps to improve mental and behavioral health and prevent burnout among health-care workers.  The bill further advocates that HHS must also research and make policy recommendations on issues such as minimizing burnout and enhancing mental and behavioral health among health care providers, removing barriers to care and treatment.   The bill also stipulated that the Centers for Disease Control and Prevention must also launch a campaign to urge health-care practitioners to seek help and treatment for mental and behavioral health issues (Congress.gov, n.d).

According to Jimenez et al (2021), the well-being of health care providers is at stake at these unprecedented times which may lead to a vicarious trauma.  These disorders might be seen as a typical reaction to clients’ stressful events, and they can result in decreased motivation, efficacy, and empathy. These changes are problematic because they have negative effects on providers’ well-being, self-esteem, some people may sense impatience or anger. Some people become easily distracted, feel frightened, or have mood swings or lose their sense of humor. intimacy, safety, and trust, and they can affect the client’s well-being and quality of care.  Recently, there has been news of health care workers particularly nurses leaving the hospital and choosing to work from home.  All these, post Covid 19 pandemic.  Frontline healthcare workers are reporting rising levels of anxiety linked to functional impairments, alcohol or drug coping, depressive symptoms such as acute hopelessness, and passive suicide ideation (Prekazi, et al, 2021).

In addition, increased workload, related to acute shortage of nurses, nurses being out sick with Covid, a shortage of medical supplies, a lack of safety for infection prevention, unfamiliarity with proper infection protocols, a lack of agreement on treatment protocols, and inconsistent organizational support were all creating anxiety and generalized stress in health care workers (Magill et al, 2020).

Frontline healthcare personnel who have been infected with COVID-19 and have been exposed to danger in the workplace are constantly exposed to potentially traumatic situations while supporting COVID-19 patients.  This has created work-related trauma.  A lot of nurses who used to be so excited about caring for patients are demoralized, unhappy and some even find it difficult to get up and go to work.

References

Congress.gov (n.d) Retrieved January 11, 2022 from

https://www.congress.gov/bill/116th-congress

Elizabeth Magill, B. ., Zoe Siegel, B. S., & Kathleen M. Pike, P. D. (2020). The Mental Health

of Frontline Health Care Providers During Pandemics: A Rapid Review of the Literature. Psychiatric Services, 71(12), 1260–1269. https://doi.org/10.1176/appi.ps.202000274

Jimenez, R. R., Andersen, S., Song, H., & Townsend, C. (2021). Vicarious trauma in mental

health care providers. Journal of Interprofessional Education & Practice, 24. https://doi.org/10.1016/j.xjep.2021.100451

Lulejete Prekazi, Vjosa Hajrullahu, Shegë Bahtiri, Blerta Kryeziu, Blertë Hyseni, Besarta

Taganoviq, & Florim Gallopeni. (2021). The Impact of Coping Skills in Post-traumatic Growth of Healthcare Providers: When Mental Health Is Deteriorating Due to COVID-19 Pandemic. Frontiers in Psychology, 12. https://doi.org/10.3389/fpsyg.2021.791568

Description of the Health Policy

The U.S. Congress has suggested numerous health reforms in the previous years that might significantly alter the nation’s health care system. H.R.1884-Protecting Pre-existing Conditions & Making Health Care More Affordable Act of 2019, presented by Democratic Congressman Richard Neal, is one such policy. This bill reforms the Patient Protection and Affordable Care Act to broaden access, affordability, and affordability of health insurance coverage.

The bill will allow the Secretary to use rulemaking to simplify health plan comparisons and selection for each plan year starting with 2020. The Secretary of Health and Human Services, through the Administrator of the Centers for Medicare & Medicaid Services, will be in charge of the funding for “Improve Health Insurance Affordability Fund.”

Background

The H.R.1884-Protecting Pre-existing Conditions & Making Health Care More Affordable Act of 2019, explored ways to reduce health care prices for Americans. These included expanding eligibility for federal health insurance subsidies, providing refundable tax credits for those with incomes between 100 and 400 percent of the federal poverty level, and reducing out-of-pocket costs and allowing Medicare to negotiate drug prices to make prescription drugs more affordable. The plan also suggested extending Medicaid, offering incentives for states to expand Medicaid and the Children’s Health Insurance Program, and subsidizing community health centers to increase health care access. Also, Health Insurance Programs and increasing funding for community health centers could lower American health care costs. The H.R.1884-Protecting Pre-existing Conditions & Making Health Care More Affordable Act of 2019 is a proposed health policy that could help all individuals in Americans with affordable health care costs. The bill offered multiple efforts to reduce health insurance premiums and deductibles and increase health care access. This plan might lower American health care prices and increase access.

Social Determinants

The Health Care Affordability Act of 2019 intended to address the increasing expenses of health care in the United States, especially for those with reduced incomes. By expanding assistance and expanding admissibility for Medicaid, offering refundable tax credits and capping out-of-pocket costs for prescription drugs, and increasing funding for community health centers, the proposed law would make health care more affordable and accessible for economically disadvantaged individuals. The Health Care Affordability Act of 2019 has been proposed as a solution to the escalating cost of health care in the United States, and there is evidence to support the proposed policy. According to studies, increasing health insurance subsidies and expanding Medicaid eligibility can reduce health care costs for individuals with low incomes. In addition, providing refundable tax credits and limiting out-of-pocket costs for prescription medications can reduce the cost of health care for low-income individuals.

Evidence Base to Support

Additionally, it has been shown that raising money for community health centers enhances access to health care services for low-income communities. In further research, researchers indicate that widening access to health care services can result in better health outcomes, especially among low-income communities. These results indicate that the proposed policy is supported by empirical evidence. In summary, the Health Care Affordability Act of 2019 has been reinforced by research.  In accordance with research studies, enhancing health insurance assistance, expanding eligibility for Medicaid, offering refundable tax credits and restricting out-of-pocket costs for prescription drugs, and boosting funding for health centers in the community could decrease healthcare costs and improve access to health care services for those with lower incomes. The aforementioned findings show that the proposed policy has the potential to enhance health outcomes, especially for those living in communities with limited incomes.

 The bill H.R. 1582, introduced in the House of Representatives, allows for a medical care tax deduction of up to $1,000 or $2,000 for the head of household on sports and fitness expenses. H.R. 1582, also called the Personal Health Investment Today (PHIT) Act of 2023, aims to reduce the cost of participating in sports and fitness programs. Using a tax credit can address the social determinant of health related to the limited access to physical activity opportunities due to cost barriers. Addressing the cost barrier to fitness activities can improve the health and well-being of all Americans. H.R. 1582 will improve access to health-promoting physical activity that would otherwise be unavailable to lower-income citizens.

            Obesity is a public health problem in adults and children, leading to many other health issues, such as hyperlipidemia, hypertension, and diabetes mellitus. Obesity increases the risk of stroke and cardiovascular disease. One way to help reduce obesity across all ages is to promote physical activity and participation in sports. The proposed legislation H.R. 1582 makes participation in fitness activities more economically feasible by allowing a tax deduction for “fitness facility memberships, physical exercise or activity programs, or equipment for a physical exercise or activity program” (Personal Health Investment Today Act, 2023). The deduction can be applied to a gym membership, exercise program, sports fees, and equipment. A tax deduction can help to increase participation in health promotion activities for children and adults who are limited by cost.

            While the tax deduction will benefit all Americans, it can mean more to parents with children playing school sports. The peer-reviewed meta-ethnography by Alcantara and Rodriguez-Martin (2022) cited the cost of activities as part of many factors that influenced children’s decreased participation in physical activities. If some of the cost can be covered through a tax deduction, the financial barrier to participation could be decreased. Schiff (2022) reports that 59% of families with children in sports have financial strain due to the cost associated with equipment, fees, and uniforms. It’s no wonder since average family spending is $693 per sport per child per year. This is part of the reason that only 22% of children in low-income households play sports regularly (Aspen Institute, 2019). If parents have difficulty paying for their children to participate in sports, they probably aren’t paying for a health membership or exercise program themselves.

            A tax deduction can hopefully promote more participation in physical activities for adults and children. Evidence shows that the cost associated with physical activities can be a barrier. Physical activity will help lower the risk of obesity and other health issues related to a less active lifestyle. While a tax deduction is an excellent beginning to health promotion on a federal level, it is merely a starting point. Other factors that could be addressed are access to nutritious food, safe recreational areas, and improved education on the benefits of increased physical activity.          

References

Aspen Institute. (2019, September 3). State of play. https://www.aspeninstitute.org/publications/state-of-play-2019-trends-and-developments/

Links to an external site.

Alcántara, P. V., & Rodríguez-Martin, B. (2022). Parents’ and teachers’ perceptions of physical activity in schools: A meta-ethnography. Journal of School Nursing, 38(1), 98-109. https://doi.org/10.1177/1059840520972005

Links to an external site.

Personal Health Investment Today Act, H.R. 1582, 118th Cong. (2023). https://www.congress.gov/bill/118th-congress/house-bill/1582

Links to an external site.

Schiff, M. (2022, October 15) Nearly 60% of families say youth sports are a “financial strain”-3 ways to budget for them. CNBC. https://www.cnbc.com/2022/10/15/nearly-60percent-of-families-say-youth-sports-are-a-financial-strain.html

A Sample Answer For the Assignment: NURS 6050 Evidence Base in Design 

Title: NURS 6050 Evidence Base in Design  

Increased administrative tasks, reduced support staff, and lack of breaks.

Yes, that is correct. Driscoll et al.’s systematic review and meta-analysis published in the Journal of Nursing Scholarship in 2018 found that higher nurse staffing ratios were associated with more positive patient outcomes, including lower mortality rates, fewer medication errors, and lower rates of hospital-acquired infections. The authors reviewed 38 studies that investigated the relationship between nurse staffing and patient outcomes in a variety of healthcare settings, including acute care hospitals, long-term care facilities, and psychiatric hospitals. The studies included in the review were conducted in several countries, including the United States, Canada, Australia, and Europe. In 2004, California became the first state to implement minimum nurse-to-patient staffing ratios in acute care hospitals (Coffman, Seago, and Spetz 2002; Spetz 2004). The mandated ratios were established by the California Department of Health Services, and they vary based on the type of unit and level of patient acuity. For example, the minimum nurse-to-patient ratio in a medical-surgical unit is 1:5, while the ratio in an operating room is 1:1 for the patient under anesthesia and 1:2 for the patient in the post-anesthesia care unit. The mandated ratios aim to ensure that there are enough nurses to provide safe and quality care to patients. Mandated staffing ratios remain a topic of debate in the healthcare industry, with some advocating for their adoption in other states, while others argue that they may not be the most effective approach to improving nurse staffing and patient outcomes.

As you mention it is essential that the government considers federally mandated staffing ratios to keep nurses in the hospital, what is your opinion on the potential challenges or drawbacks associated with federally mandated staffing ratios in nursing, and how can these be addressed to ensure successful implementation and compliance?

References

Coffman, J. M., J. A. Seago, and J. Spetz. 2002. “Minimum Nurse-to-Patient Ratios in Acute Care Hospitals in California. Health Affairs 21 (5): 53– 64.

Driscoll, A., Grant, M. J., Carroll, D., Dalton, S., Deaton, C., Jones, I., Lehwaldt, D., McKee, G., Munyombwe, T., & Astin, F. (2018). The effect of nurse-to-patient ratios on nurse-sensitive patient outcomes in acute specialist units: a systematic review and meta-analysis. European journal of cardiovascular nursing17(1), 6–22. https://doi.org/10.1177/1474515117721561Links to an external site.

Mark, B. A., Harless, D. W., McCue, M., & Xu, Y. (2004). A longitudinal examination of hospital registered nurse staffing and quality of care. Health services research39(2), 279-300.