Assignment: NURS 6050 Advocating for the Nursing Role in Program Design and Implementation

Assignment: NURS 6050 Advocating for the Nursing Role in Program Design and Implementation

Assignment: NURS 6050 Advocating for the Nursing Role in Program Design and Implementation

As their names imply, the honeyguide bird and the honey badger both share an affinity for honey. Honeyguide birds specialize in finding beehives but struggle to access the honey within. Honey badgers are well-equipped to raid beehives but cannot always find them. However, these two honey-loving species have learned to collaborate on an effective means to meet their objectives. The honeyguide bird guides honey badgers to newly discovered hives. Once the honey badger has ransacked the hive, the honey guide bird safely enters to enjoy the leftover honey.

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Much like honeyguide birds and honey badgers, nurses and health professionals from other specialty areas can—and should—collaborate to design effective programs. Nurses bring specialties to the table that make them natural partners to professionals with different specialties. When nurses take the requisite leadership in becoming involved throughout the healthcare system, these partnerships can better design and deliver highly effective programs that meet objectives.

In this Assignment, you will practice this type of leadership by advocating for a healthcare program. Equally as important, you will advocate for a collaborative role of the nurse in the design and implementation of this program. To do this, assume you are preparing to be interviewed by a professional organization/publication regarding your thoughts on the role of the nurse in the design and implementation of new healthcare programs.

To Prepare:

  • Review the Resources and reflect on your thinking regarding the role of the nurse in the design and implementation of new healthcare programs.
  • Select a healthcare program within your practice and consider the design and implementation of this program.
  • Reflect on advocacy efforts and the role of the nurse in relation to healthcare program design and implementation.

The Assignment: (2–4 pages)

In a 2- to 4-page paper, create an interview transcript of your responses to the following interview questions:

  • Tell us about a healthcare program, within your practice. What are the costs and projected outcomes of this program?
  • Who is your target population?
  • What is the role of the nurse in providing input for the design of this healthcare program? Can you provide examples?
  • What is your role as an advocate for your target population for this healthcare program? Do you have input into design decisions? How else do you impact design?
  • What is the role of the nurse in healthcare program implementation? How does this role vary between design and implementation of healthcare programs? Can you provide examples?
  • Who are the members of a healthcare team that you believe are most needed to implement a program? Can you explain why?

The Care at Home (CAH) Medicaid Waiver Program Sample Paper

Tell us about a healthcare program, within your practice. What are the costs and projected outcomes of this program?

The Care at Home (CAH) Medicaid waiver program will be a state-run community-based program that allow severely disabled children to access home care and healthcare coverage within the community. The waiver program is based on the proposition that children with disabilities should have a proper support to enable them to become active participants in determining their future. The waiver program is a federally approved deferral of the Medicaid rules to enable disabled children to remain home and still benefit from the Medicaid coverage (Yingling et al, 2019).

Typically, such a waiver program disregards the guardian’s or parent’s resources and income when determining the eligibility for the means-tested program. This allows parents to benefit from services that they would otherwise not benefit from due to their low-income levels. The program the program is funded with a mix of both state and federal dollars and overseen by the state health agency. It allows physically disabled children to remain with their families at home while receiving healthcare, nursing and vehicle and home modifications.

  • Who is your target population?

This program benefits families that struggle with meeting their healthcare costs: drug coverage for disabled children and uncovered therapies. It especially targets autistic children and at-risk infants because of their low survival rates. 

  • What is the role of the nurse in providing input for the design of this healthcare program? Can you provide examples?

The program spans from financing home care for children with disabilities to ensuring an adaptive, healthy and safe home environment for the children. As such, nurses are directly involved in ensuring safety and wellbeing of the beneficiaries by designing their living environment and ensuring those environments respond to each child’s unique disabilities.

Depending on the child’s specific needs, the nurse is responsible not only for care delivery but also for home modification. Considering home modification may be overwhelming to some families, the nurses are directly involved in advising on the necessary changes that parents or guidance need to make within the home environment to guarantee safety and wellbeing of the beneficiary children.

Key to the nurses’ role is ensuring that the home environment is accessible so that those using wheelchair can easily and safely get in and out of the rooms. The nurse would then present these environment modification requirements to the program design committee to justify the waiver and support other crucial decisions regarding the program. For instance, disabled children whose home environment require more modifications are prioritized as beneficiaries compared to those whose home environment require lesser modification. The idea is that those who require more home modification would need more resources, and are therefore eligible for the program’s support.

The nurse also plays a key role in designing the respite component of the program. Because respite is provided at home by the nurses or other healthcare professionals, these caregivers will help in design the schedule for respite services as well as the resources required for those services. Typically, the respite services relieve families from the challenges associated with care or deliver the care when the families are not around.

Because the nurse services are the most needed and most difficult to access as a result of the shortage of nurses (Marć et al 2019), nurses’ input is required in terms of designing the care shifts depending on the needs of each beneficiary. More importantly, the nurses will play a significant role in the program evaluation stages, where they provide feedback to the program advisory committee on the program’s impact and any points for improvement.

  • What is your role as an advocate for your target population for this healthcare program? Do you have input into design decisions? How else do you impact design?

Information is a key resource for advocates; they need to have facts about the program and how it addresses the children’s special needs. Typically, the advocate is responsible for knowing the when, how, who and where about the program; documenting the information and using them as references during the program design process. Similarly, the advocate must be extremely aware of the special needs involved, including the relevant federal laws so that they can inform the program design process form a legal standpoint. 

The advocate is also responsible for liaison between parents and the service providers. They are responsible for ensuring that there is a good relationship between the caregivers and the parents because sometimes it is easier for the two set of individuals to fall into a blame game whenever something is not right. Therefore, it is the advocate’s role to ensure that the disappointments and bureaucracies involved in the program does not impede the relationship between the program managers, caregivers and parents. They are the program’s vision keepers and are responsible for advocating for meeting the kid’s needs regardless of the bureaucracies involved. 

  • What is the role of the nurse in healthcare program implementation? How does this role vary between design and implementation of healthcare programs? Can you provide examples?

Community health nurses role in implementing the program spans from protecting, promoting and preserving the children’s health. As per Barbero et al (2021), their roles are based on various fundamental principles including educating patients on making healthy choices and maintaining healthy lifestyles and providing direct care.  the nurses primarily focus on delivering the children’s health needs. They coordinate with physicians and other health workers to ensure the children receive care that is equally as good as what they would receive in the hospital.

When they make home visits, they assess the children’s health conditions, deliver wound care, check vital signs (e.g. blood pressure) and manage prescription medicine when a child needs it. Furthermore, they are responsible for educating families and other community members on maintaining the children’s health and wellbeing (Assefa et al, 2019). Nurses also act as the gatekeepers for the children’s rights and protection, primarily protecting them from child abuse, sexual harassment, poor nutrition and teen pregnancy. 

These roles are different from their program design roles in many senses. For instance, their program design roles involve identifying when to visit each home and how long they should take in each home. Contrastingly, the implementation role involves determining what they do in every visit, including conducting medical checks on the patients.  In short, program design mainly entails the where, how and when the services are delivered, while program implementation roles entail what services are delivered and by who.

  • Who are the members of a healthcare team that you believe are most needed to implement a program? Can you explain why?

Medicaid senior leaders are important in the implementation process because they must communicate with the service providers about the program’s success and areas of improvement. According to Schwartz et al (2018), keeping the Medicaid senior leadership will help manage expectations and enhance the leader’s support. Other state agencies may also be important in the implementation process. This is especially for the purpose of gaining feedback and identifying any potential partnership benefits between the care management team and the program (Assefa et al, 2019). For example, the state’s Department of Health Disability Program   might need to partner with the program managers in exploring other opportunities for enhancing the program.

The providers should also be involved in the implementation stage to ensure they buy in the idea. This can be done by forming provider advisory groups or board that provide feedback on the program strategies, guidelines and measures (Barbero et al, 2021). They may also help in developing quality improvement goals based on reported performance. 

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References

Assefa, Y., Gelaw, Y. A., Hill, P. S., Taye, B. W., & Van Damme, W. (2019). Community health extension program of Ethiopia, 2003–2018: successes and challenges toward universal coverage for primary healthcare services. Globalization and Health, 15(1), 1-11. https://link.springer.com/article/10.1186/s12992-019-0470-1

Barbero, C., Mason, T., Rush, C., Sugarman, M., Bhuiya, A. R., Fulmer, E. B., Feldstein, J., Cottoms, N. & Wennerstrom, A. (2021). Processes for Implementing Community Health Worker Workforce Development Initiatives. Frontiers in Public Health, 9, 828. https://doi.org/10.3389/fpubh.2021.659017

Marć, M., Bartosiewicz, A., Burzyńska, J., Chmiel, Z., & Januszewicz, P. (2019). A nursing shortage–a prospect of global and local policies. International Nursing Review, 66(1), 9-16. https://doi.org/10.1111/inr.12473

Schwartz, P. M., Kelly, C., Cheadle, A., Pulver, A., & Solomon, L. (2018). The Kaiser Permanente Community Health Initiative: A decade of implementing and evaluating community change. American Journal Of Preventive Medicine, 54(5), S105-S109. DOI:https://doi.org/10.1016/j.amepre.2018.02.004

Yingling, M. E., Bell, B. A., & Hock, R. M. (2019). Comparing neighborhoods of children with autism spectrum disorder in a Medicaid waiver program and a state population, 2007–2015. Psychiatric Services, 70(11), 1034-1039. https://doi.org/10.1176/appi.ps.201800479

Required Readings

Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones & Bartlett Learning.

  • Chapter 5, “Public Policy Design” (pp. 87–95 only)
  • Chapter 8, “The Impact of EHRs, Big Data, and Evidence-Informed Practice” (pp. 137–146)
  • Chapter 9, “Interprofessional Practice” (pp. 152–160 only)
  • Chapter 10, “Overview: The Economics and Finance of Health Care” (pp. 183–191 only)

American Nurses Association (ANA). (n.d.). Advocacy. Retrieved September 20, 2018, from https://www.nursingworld.org/practice-policy/advocacy/

Centers for Disease Control and Prevention (CDC). (n.d.). Step by step: Evaluating violence and injury prevention policies: Brief 4: Evaluating policy implementation. Retrieved from https://www.cdc.gov/injury/pdfs/policy/Brief%204-a.pdf

Congress.gov. (n.d.). Retrieved September 20, 2018, from https://www.congress.gov/