Answer

Health Policy

In these modern days, nurses have an obligation to take a leading role in the formulation of healthcare policy and engage in advocacy to promote health care.  The Doctor Nursing Program Degree (DNP) recommended by the American Association of College of Nursing (AACN) has essentials critical in fostering better quality health care. In this reflective paper, the focus is to assess learning impacts on skills, knowledge and integrative abilities in meeting DNP essentials and sub competencies pertaining to health care policy for advocacy in health care.

The course has exposed me to the concept of Health policy in the health care. Important skills and knowledge gained from this encounter is the importance of policies in transforming healthcare (American Association of Colleges of Nursing, 2016).  Policy frameworks can either facilitate or impede delivery of healthcare services or can hamper providers’ ability to render and engage in practice to address various needs in healthcare (American Association of Colleges of Nursing, 2016). The role of DNP in the holistic aspect of Health care Policy cannot be overlooked.

The DNP play a critical role in the development and evaluation of health policies. The nurses have to possess skills and competencies to critically analyse health policies to advocate for social justice and nursing profession.  Making proposals on the legislations in the political area touching on the health aspect is also important role for the DNP to expedite. Nurses have a mandate to contribute to the entire process of development of policy through political actions (Maryland & Gonzalez, 2012). This is attested by the fact that quite a number of organizations and institutions such as American Nurses Association, International Council of Nurses, and North American Organizations among others enable voice of the nurses to be heard (Cristina, Karen & Roya, 2014).  Similarly, through employers’ policy committees, the nurses have an opportunity to partake in the engagements concerning health related issues and policies. Nevertheless, I have learned that, this role is marred with challenges especially encouraging nurses into getting involved in active politics. Some of the barriers to this include, resources to develop skills in policy participation, time to engage in aspects outside nursing work and lack of understanding the importance of them getting involved in nursing organizations.

In addition, Ehrenreich (2002) concur that DNP has the responsibility of assuming leadership role on behalf of nursing professionals and the public in engaging in process of policy development. Other stakeholders such as nurses, health professionals and the members of public remain integral in contributing to the development of the policies through their proposals. They have the opportunity to provide their views and comments through various forums such as public forums, suggestion boxes and seminar among other forums. According to Maryland & Gonzalez (2012), nurses on daily basis encounter with patients with difference experiences upon which they can draw insights to impact on the public health policies. Therefore, involving them in the policy formulation and development will go miles in impacting on the quality of healthcare.

Furthermore, Lee (2014) argues that advancement of healthcare to pay for performance model and adoption of medical centres need to demonstrate the safety of care evidenced through improved practices and reduced cases of postoperative adverse events. Such aspects would require implementation of policies that can improve patient outcomes and require involvement of stakeholders such as nurses, patients, physicians, caregivers, payers and employers (Akram, Forough, Mohammad, &Shahrzad, 2014).  Non obvious stakeholders including board members such as CEO, directors of nursing, chief medical officers among others have vested interest in promoting quality and safety of care that achieve patient satisfaction, is cost effective, and innovative. Therefore, these obvious stakeholders like nurses and patients have a role in influencing some of the policies and processes that can help improve patient outcome and at the same time promoting success of an organization.

I have also learned and appreciated the need for effective leadership in the development and implementation of different kinds of policies in health care. Some of the health polices are meant for institutions, others serve local jurisdiction, states, federal government, and some apply at the international level. Example of such policies is the Affordable Care Act (ACA) designed to address the medical costs of the citizens of United States. The policy focussed on making insurance affordable to many citizens by expanding Medicaid program and supporting innovations in health care helping lower costs (Healthvare.gov, 2017). For this policy to go through, it requires exhibition of leadership from health professionals who give insights. They also helped in shaping the public opinions that culminated to its passage.  This example is a good illustration of how strong leadership can be critical in ensuring that the vision of transforming health care through policies can be realised. DNP has to develop leaders that can take part in the negotiations and discussions, as well serve with their professionals and remain accountable as they work with other leaders and other health professionals to trigger changes and reforms through such policies (National Academies & National Academies, 2011).

Furthermore, I have gained knowledge on the significance of DNP that can positively influence the decisions of policy makers either to accept or reject certain suggestions that would make part of the policy to guide provision of health care services (Nursing Alliance for Quality Care, 2017).  The influencers have to participate through getting involved in the committees, task forces, board meetings, at institutional, local, state, national, regional, and even international levels with the objective of improving healthcare delivery and the outcomes. The influencing part can be through whistleblowing, rejecting sections or entire policies and or supporting policies based on critical analysis of their impacts on the service delivery in healthcare. An organization such as International Council of Nurses (ICN) has described the goal of influencing health policies as being one of the core mandates of organizations (Cristina, Karen, & Roya, 2014).

Education remains key and central in healthy policy and responsibility of nurses to disseminate knowledge and skills to others.  DNP has a core mandate of educating other nurse professionals and other stakeholders on matters related to health policy, nursing, and patient care outcomes to improve health outcomes. According to National League for nursing (2015), NDP have strong leadership skills and expertise in evidence based practice to influence health reform and improve quality care. Hence, education imparts on skills and knowledge that leads to proper decision making. Nurses would be better placed to support and make appropriate change and recommendation concerning health aspects if they have enough knowledge on the impacts of such policies on service delivery.

Have also come to appreciate the role of advocacy the DNP performs for the nursing profession within the healthcare communities. The DNP have the competencies, skills and knowledge critical in advocating for the rights and the privileges of the nursing fraternity.   Advocacy concerns getting majority people on one’s side to promote or reinforce change in program, environment, policy or legislation (Negarandeh et al., 2006).  The DNP will therefore advocate for nurses and stakeholders on matters such as economic, education, healthcare system, and legislative arena among many other. For instance, as economy faces challenges, DNP has to advocate for better salaries and working environments (American Federation of State, County and Municipal Employees, 2017). On issues healthcare systems, they have to advocate for adoption of improved healthcare systems to address the challenges faced in their execution of tasks such as the e-health records etc. On educational matters, they have a right to advocate for increased enrolment in nursing professional and increase of medical schools and equipment for training. On legislation front, they have to advocate for policies and laws that would create a conducive environment for them to deliver quality health care (Nursing Solutions, 2016).  Issues of socio-economic disparities such as wages and salaries are also key when formulating the policies (Alder, Newman, 2002). Examples of organizations on the forefront working to ensure that nurses have the opportunity to speak with one voice to influence on health policy and help in advancing the profession of nursing include International Council of Nurses and Federation of National Nursing Associations (Benton, 2012). Bethany Hall-Long is a good example of nurse legislator in the Delaware General Assembly is a demonstration that nurses are bets advocates for improved health policy and public health (National League for Nursing, 2015).

Healthcare encompasses different aspects, which require continuous development of leadership for healthcare policy to shape financing of health care, ensure regulations and delivery of effective care (American Association of Colleges of Nursing, 2016). Leaders have to be continuously developed, through training and mentorship to have in-depth understanding of the overall functioning of healthcare. This would enable them become a resource in the shaping of policies that concerns financial management and delivery of quality healthcare in the healthcare facilities.  Therefore, it is critical that leaders understand the needs and the situations of health care to take a leading role in shaping the vision on the expected outcomes of their healthcare systems.

Social justice advocates in society play important function in securing justice in health care organizations. Personally, I vehemently agitate for social justice in all spheres of society, especially in healthcare.  There is need for health care systems to adhere and remain dear to values espousing for social justice, equity and upholding to ethical policies when providing health care to clients (Los Angeles County Department of Public Health, 2013). The DNP have to ensure that the health policies do not tolerate any form of discrimination, victimization and denial of accessibility to quality health care. The bill of rights in the constitution must be upheld when delivering care to patients (Amanda Cassidy (2012). The policies have to ensure that the rights of health providers and the clients are respected. For instance, accessibility to affordable care is key.  Health care plans such as the controversial Affordable Care Act should be evaluated to establish viability in helping low income earners access to affordable quality health care (Reisman, 2015). Furthermore, professional codes of conduct and ethics remain key in delivery of quality health care and must always be put to consideration when developing health proposals.

As I conclude, the DNP essential on health care policy for advocacy in health care remain critical in the overall safety and quality of patient outcome. Health care policies affect all the stakeholders in healthcare and scrutiny of such policies by DNP would help seal loopholes helping achieve quality healthcare.  This essential and its sub competencies touch on many other important aspects that would go miles in transforming health care. Other important aspects include, ensuring proper leadership, role of influencing policy makers, educating others, advocating for the others in the profession, developing leadership to help in the transformation and advocating for social justice, ethical policies and equality. Allowing other stakeholders to contribute their views in health policy formulation is equally important in promoting quality outcomes. I must also state that the experience of the course has been awesome, exposing me to the roles and the impact DNP have on transforming and impacting on health care. Despite challenges experienced by NDP in participating in this roles, the benefits surpasses the costs and therefore, we can only experience negative or positive changes in healthcare if  the DNP performs their roles with diligence.