NR 503 Week 8 Discussion
Health Policy and Ethics
This discussion board content is intended to facilitate learning for students through engaging dialogues as they achieve the desired learning outcomes/competencies associated with their course in a manner that empowers them to organize, integrate, apply and critically appraise their knowledge to their selected field of practice.
The use of discussions provides students with opportunities to contribute graduate level-appropriate knowledge and experience to the topic in a safe, caring, and fluid environment that models professional and social interaction. The ebb and flow of a discussion is based upon the composition of student and faculty interaction in the quest for relevant scholarship.
Participation in the discussion generates opportunities for students to actively engage in the written ideas of others by carefully reading, researching, reflecting, and responding to the contributions of their peers and course faculty. Discussions foster the development of members into a community of learners as they share ideas and inquiries, consider perspectives that may be different from their own, and integrate knowledge from other disciplines.
Activity Learning Outcomes
Through this assignment, the student will demonstrate the ability to:
- Synthesize knowledge of population to the role of political advocacy as an Advanced Practice Nurse. (CO 5, 7)
- Appraise ethical and legal principles to the provision of care by the Advanced Practice Nurse (CO 5, 7)
Due Date:
- Initial prompt due by Wednesday, 11:59 PM MT of week 8
- One peer and one faculty or two peer posts due by Saturday 11:59 PM MT of week 8
A 10% late penalty will be imposed for initial discussions posted after the weekly deadline regardless of the number of days late. No postings will be accepted after 11:59pm MT on Saturday (i.e. student will receive an automatic 0). Week 8 discussion closes on Saturday at 11:59pm MT.
Total Points: 60 Points
Assignment Requirements
- Go to your state government web page. Find one health policy enacted within the last two (2) years at the state level. Write down the bill number and the sponsors of the bill and include this information in your initial post.
- Write a minimum of a one-page critical analysis summary of the policy. (250 words double spaced, APA). Your summary should integrate the concepts of advocacy, population health, and the ANA ethical statements (“The Code”), and course readings, to include a minimum of one course scholarly article (provided within the course). Be sure to speak to the role of advocacy and population health.
- Respond to a minimum of two (2) peers/faculty posts with one (1) paragraph of 4-5 sentences integrating one scholarly source utilized in an in-text citation/APA.
Posting Directions
- Posts should be made on a minimum of 3 separate days/dates.
- All faculty replies to students must be responded to directly in the discussion board.
- Minimum posting is:
- Initial discussion board post to the weekly prompt, two peer posts (if there are no faculty postings), or one peer post and a faculty post.
**To see view the grading criteria/rubric, please click on the 3 dots in the box at the end of the solid gray bar above the discussion board title and then Show Rubric.
Sample Discussion Post
In 2022, the HR73 bill was sponsored by the Kentucky House of Representatives. This bill was enacted to identify March as National Colorectal Awareness Month with March 4, 2022 recognized as Dress in Blue Day (Kentucky General Assembly [KGA], 2022). It was recognized that the Colon Cancer Screening and Prevention program in Kentucky is one of the state’s most successful public health programs (KGA, 2022). The partnership between the KGA and the Colon Cancer Screening and Prevention program has increased screening rates from 34.7 percent to 69.8 percent improving more than any other state advancing Kentucky’s ranking from 49th to 20th (KGA, 2022). Since screening rates have improved, colorectal cancer incidence rates and mortality rates have been reduced (KGA, 2022). This translated to 30 less Kentuckians diagnosed with colorectal cancer yearly (KGA, 2022). March is also recognized as National Colorectal Cancer month by the Colorectal Cancer Alliance to help spread disease awareness and reinforce screening importance (KGA, 2022). The bill ends with summation that the House of Representatives honors the Kentucky Colon Cancer Screening and Prevention Program and that the month of March as of 2022 will be established as National Colorectal Cancer Awareness month with March 4, 2022 as Dress in Blue Day honoring volunteers, advocates, and survivors (KGA, 2022). This policy on colorectal cancer screening integrates the concepts of advocacy, population health, and the American Nurses Association ethical code.
Advocacy is a principle promoted by the colorectal cancer screening awareness bill enacted by the House of Representatives. The American Association of Colleges of Nursing task force established advocacy of healthcare policy into practice as one of the essentials and core competencies for nurse practitioners (NPs) (Joel & Campbell, 2020). Advocacy for ethical policies that promote equity, access, cost, and quality of healthcare and for policies that encourage healthy and safe practice environments are some of the NP responsibilities as established by the National Organization of Nurse Practitioner Faculties (Filipovich, 2022). Colorectal cancer is the third most common cancer in men and women (Shaukat et al., 2021). Most colorectal cancers develop through adenoma-carcinoma sequence presenting opportunities to prevent cancer by detecting and removing precursor lesions and identifying colorectal cancer in its earliest, curable stages (Shaukat et al., 2021). Advocacy for colorectal cancer screening should be promoted by NPs in practice to enhance early detection of the disease. Screening education should be integrated into sick visits and wellness visits for patients who may be at risk.
Population health is an aspect involved in the colorectal cancer screening bill. Population determinants of health that may contribute to development of colorectal cancer include physical inactivity, inadequate intake of fruits and vegetables, increased consumption of processed meats, being overweight or obese, alcohol consumption, and tobacco use (Eggers, 2019). Kentucky’s population was noted to have the second highest tobacco use in the nation, less than a tenth of the population eats enough fruits or vegetables, and more than a third do not engage in daily exercise (Eggers, 2019). It was also recognized that two-thirds of adults aged 20 and over are overweight or obese (Eggers, 2019). The factors increase the need for NPs in Kentucky to incorporate colorectal awareness and screening into practice.
The American Nurses Association (ANA) has a variety of ethical statements for NPs to follow in practice. One of the provisions listed by the ANA (2022) includes nursing promotion, advocacy, and protection of the rights, health, and safety of patients. In relation to the House bill promoting colorectal cancer awareness, NPs can achieve this ANA ethical standard by practicing primary, secondary, and tertiary prevention to promote the best healthcare for patients. Primary prevention involves health promotion for disease prevention (Vitale & Cupp, 2020). The NP may practice primary prevention for colorectal cancer by performing nutrition and education counseling with patients to promote intake of a well-balanced diet, increased fruit and vegetable intake, and increasing physical activity. Secondary prevention consists of early detection and prompt treatment of a condition at the earliest stage possible (Vitale & Cupp, 2020). It is recommended by the U.S. Preventive Services Task Force (USPSTF) that adults aged 45 to 75 be screened for colorectal cancer (Centers for Disease Control and Prevention [CDC], 2022). There are several screening methods available including stool testing, flexible sigmoidoscopy, colonoscopy, and virtual colonoscopy (CDC, 2022). The NP should discuss the available methods for detection during visits and provide referral for patients in this age range to receive colorectal cancer screening. A counterexample pertaining to secondary prevention in colorectal cancer screening would be the NP not recommending screening for this targeted age range of patients due to various factors, such as overscheduling of patients leading to lack of time for patient education on screening. Tertiary prevention involves disease treatment measures to restore optimal function and prevent disability (Vitale & Cupp, 2020). This may be enacted for patients who have received a diagnosis of colorectal cancer and the NP provides annual referral for colonoscopy to determine if the cancer reappears or if any new polyps develop.
Incorporation of the ANA ethical standards along with primary, secondary, and tertiary prevention promote the conceptual model of nursing and public health. This conceptual model consists of using health promotion and nursing activities to enhance or restore and maintain wellness throughout the lifespan and to attain the highest quality of life for populations (Fawcett & Ellenbecker, 2015). Advocacy for health promotion and wellness is one of the duties of NPs. In relation to the House bill advocating for colorectal cancer awareness in Kentucky, NPs play a role in incorporating this bill into their practice to increase education regarding disease prevention, screening methods and recommendations set forth by entities such as the USPSTF, and consistent disease monitoring to promote population health.
References
American Nurses Association. (2022). Code of ethics for nurses with interpretive statements. https://www.nursingworld.org/coe-view-onlyLinks to an external site.
Centers for Disease Control and Prevention. (2022, February 17). Colorectal cancer screening tests. https://www.cdc.gov/cancer/colorectal/basic_info/screening/tests.htmLinks to an external site.
Eggers, C. (2019, March 25). Kentucky lifestyles, genetics contributing to high colon cancer rates. Bowling Green Daily News. https://www.bgdailynews.com/news/kentucky-lifestyles-genetics-contributing-to-high-colon-cancer-rates/article_2a3c1bd6-b17b-5245-a5a9-bd4706553e74.htmlLinks to an external site.
Fawcett, J., & Ellenbecker, C. H. (2015). A proposed conceptual model of nursing and population health. Nursing Outlook, 63(3), 288-298. https://doi-org.chamberlainuniversity.idm.oclc.org/10.1016/j.outlook.2015.01.009Links to an external site.
Filipovich, C. (2022). Effective state-level APRN leadership in health policy. In K. A. Goudreaux & M. C. Smolenski (Eds.), Health policy and advanced practice nursing: Impact and implications (3rd ed., pp. 85-94). Springer Publishing Company, LLC.
Joel, L. A., & Campbell, I. M. (2020). Implications of global health in population-based nursing. In A. L. Cupp (Ed.), Population-based nursing: Concepts and competencies for advanced practice (3rd ed., pp. 289-318). Springer Publishing Company, LLC.
Kentucky General Assembly. (2022). HR73. https://apps.legislature.ky.gov/lrcsearch#tabs-6Links to an external site.
Shaukat, A., Kahi, C. J., Burke, C. A., Rabeneck, L., Sauer, B. G., & Rex, D. K. (2021). ACG clinical guidelines: Colorectal cancer screening 2021. The American Journal of Gastroenterology, 116(3), 458-479. https://doi.org/10.14309/ajg.0000000000001122Links to an external site.
Vitale, P. A., & Cupp, L. (2020). Epidemiological methods and measurements in population-based nursing practice: Part I. In A. L. Cupp (Ed.), Population-based nursing: Concepts and competencies for advanced practice (3rd ed., pp. 53-86). Springer Publishing Company, LLC.
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