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    Review Chapter 3 of Milstead, J. A. (2016). Health policy and politics: A nurse’s guide (5th ed.). Burlington, MA: Jones and Bartlett Publishers.
    In the first assignment, you reflected on whether the policy you would like to promote could best be achieved through the development of new legislation, or a change in an existing law or regulation. Refine as necessary using any feedback from your first paper.
    Contemplate how existing laws or regulations may affect how you proceed in advocating for your proposed policy.
    Consider how you could influence legislators or other policymakers to enact the policy you propose.
    Think about the obstacles of the legislative process that may prevent your proposed policy from being implemented as intended.
    To complete:

    Part Two will have approximately 3–4 pages of content plus a title page and references. Part Two will address the following:

    Explain whether your proposed policy could be enacted through a modification of existing law or regulation or the creation of new legislation/regulation.
    Explain how existing laws or regulations could affect your advocacy efforts. Be sure to cite and reference the laws and regulations using primary sources.
    Provide an analysis of the methods you could use to influence legislators or other policymakers to support your policy. In particular, explain how you would use the “three legs” of lobbying in your advocacy efforts.
    Summarize obstacles that could arise in the legislative process and how to overcome these hurdles.
    Paste the rubric at the end of your paper.

    Outstanding Performance Excellent Performance Competent Performance Proficient Performance Room for Improvement
    Main Posting:
    Response to the discussion question is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources.
    44 (44%) – 44 (44%)
    Thoroughly responds to the discussion question(s)

    is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources.

    supported by at least 3 current, credible sources


Subject Nursing Pages 5 Style APA


Week 5 Policy Assignment: Developing an Advocacy Campaign

            A new federal policy is being proposed to allow for monthly redistribution of nurses across states and facilities from high nurse surplus areas to areas or facilities that faces nurse shortages. The rationale of enacting a new policy is that it will facilitate effective utilization of the existing nursing workforce and maintenance of dynamic but cost-effective nurse populations in hospitals and/or clinics. Besides, it may help resolve burnout issues since nurses across different hospitals and clinics in the country will be serving appropriately similar number of patients per day since it will be determined by patient-inflows and outflows data collected every month. Adequate nurse staffing levels results in reduction of medication and medical errors as well as reduction of hospital readmissions, patient mortality, and length of stay. Besides, it leads to reduction of the number of preventable events such as pressure ulcers, patient falls, central line infections, and healthcare-associated infections. In additions, patients can benefit from avoidance of care costs due to reduction of unplanned readmissions (Lippincott Solutions, 2018). A consideration of existing laws, legislator influencing strategies, and the challenges that may face implementation of the new policy is the focus of this paper. 

            Existing laws and regulations may impact advocacy for enactment of the proposed policy. The federal law 42 CFR 482.23 affirms that maintenance of adequate nurse staffing levels is one of the condition of participation of hospital and healthcare providers to the Centers for Medicare and Medicaid Services (Federal Register, 2019). The new policy will support or facilitate implementation of the federal policy – 42 CFR 482.23 (Federal Register, 2019). In addition, The Safe Staffing for Nurse and Patient Safety Act of 2018 (S. 2446, H.R. 5052) requires established committees to develop nurse staffing plans for their patients (Federal Law Regulations, 2019). In which case, the new law will allow such committees to identify nurse surplus from other states and facilities and initiate relocation of some staff members from other hospitals that may be overstaffed at a given point in time. Besides, the new proposed law will facilitate for adequate staffing of a 24-hour licensed nursing services in accordance with the Federal Law and Regulations on Nurse Staffing Issues (as contained in the Nursing Home Reform Act of 1987) (Federal Law Regulations, 2019). The new law may as well result in a positive impact at the state level; especially in states other states that do not have nursing laws with exception of 11 states that include Oregon, Texas, Washington, New York, California, Massachusetts, Illinois, Nevada, Rhode Island, Vermont, and Connecticut (Shin et al., 2018).

            Legislators and other policymakers can be influenced using the three-legged stool of effective lobbying to enable enactment of the proposed policy. The three-legged stool approach can also be described as a behind the scenes efforts of policy advocacy and policy making. The first leg of the stool approach is to identify and involve a professional lobbyist organization or group since lobbying and the associated bill has a budget. Leg two of the stool for supporting the bill is to involve and organize the grassroots constituents to support the congressman who will sponsor the bill. A nurse who proposes this bill should be ready to answer any question that will be asked by the legislator as to how many letters and phone calls will the grassroots advocacy campaign entail. The state board of nursing should be contacted to advance the advocacy campaign.  During the first meeting with the legislator, professional communication skills should prevail. Lastly, the third leg of the stool is the legislator’s will, time, and effort to woo voters to pass the bill during the voting phase. The lobbyist and the advocate should compete for legislator’s time and attention for the success of the last stage of the three-legged stool approach (Milstead, 2016).

            The legislation process may be faced with certain challenges and obstacles, thus, preventing it to be implemented as intended. The first challenge is that lack of democratic and shared decision making process may curtail the implementation process. All stakeholders must be involved and let to own-up the law to ensure that is effectively implemented across all states and hospitals. Secondly, lack of transparency during the legislation process may have negative impacts on the bill. Regardless of the complexity of the legislative procedures the decision making process must be as transparent and possible. The last challenge is inefficiency of individual hospitals to collect data and determine whether they are over-staffed or understaffed depending on patient inflows and outflows in a timely manner. All hospitals need to be effective on this for realization of success in implementation of the proposed law (Steiner & Woods, 2009).

            In conclusion, the proposed law will facilitate for redistribution of nurses across different states and hospitals. The new law will not contravene existing federal nurse staffing laws but will help facilitate implementation of the associated laws. The proposed law may likely be passed into a law if the three-legged stool for effective lobbying will be utilized. Lastly, implementation challenges such as lack of shared-decision making, lack of transparency, and associated inefficiencies must be addressed during the legislation process.




Federal Law Regulations. (2019). Federal Law and Regulation on Nurse Staffing Issues (as contained in the Nursing Home Reform Act 1987). Retrieved on Jan 03, 2019 from, https://theconsumervoice.org/uploads/files/issues/Federal-Law-Regulations-Final.pdf

Federal Register. (2019). 42 CFR 482.23 – Condition of participation: Nursing services. Retrieved on Jan 03, 2019 from, https://www.govinfo.gov/app/details/CFR-2011-title42-vol5/CFR-2011-title42-vol5-sec482-23

Lippincott Solutions. (2018). Update on nursing staff ratios. Retrieved on Jun 03, 2019 from, http://lippincottsolutions.lww.com/blog.entry.html/2018/03/08/update_on_nursingst-HJoe.html

Milstead, J. A. (2016). Health policy and politics: A nurse’s guide (5th ed.). Burlington, MA: Jones and Bartlett Publishers.

Shin, J.H., Koh, J.E., Kim, H.E., Lee, H.J., & Song, S. (2018). Current status of nursing law in the United States and implications. Health Systems and Policy Research, 5(1), 1-7. DOI: 10.21767/2254-9137.100086.

Steiner, J., & Woods, L. (2009). EU Law (10th ed.). Oxford: Oxford University Press.
















Appendix A:

Communication Plan for an Inpatient Unit to Evaluate the Impact of Transformational Leadership Style Compared to Other Leader Styles such as Bureaucratic and Laissez-Faire Leadership in Nurse Engagement, Retention, and Team Member Satisfaction Over the Course of One Year

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