NR 506 Week 2: Policy-Priority Selection
NR 506 Week 2: Policy-Priority Selection
NR 506 Week 2: Policy-Priority Selection
The healthcare policy that I have chosen is Gun Safety and Public health. I have chosen this topic because lack of gun safety has taken over America. I work in a Pediatric Emergency department where we maybe saw 1-2 gunshot victims maybe every couple of months to several gunshot victims every month. We have treated a majority of younger children who just were at the wrong place at the wrong time. Some have lost their lives to the streets. The Pediatric gun violence policy is what should be used to protect our children from gun violence. The American academy of pediatrics and it’s 2012 policy statement, Preventing Firearm-Related Injuries in the Pediatric Population, States that the absence of guns from children’s homes and communities is the most reliable and effective measure to prevent firearm-related injuries in children and adolescents “ (AAP, 2009). The ANA wrote an great article called American Nurses Association Urges Nurses to Help stop Gun Violence after the horrible incident in Orlando Florida (ANA, 2016). The ANA has acknowledged this day calling for a sensible gun control mass, including one that will remove a ban on the CDC and Prevention from studying gun violence (ANA, 2016). It is time for all of us to achieve gun control legislation at the federal and state levels (ANA, 2016). Gun Violence has reach an all high and something must be done to stop it. I would like to see gun availability not so easy to obtain. There should be a ban on assault weapons and one should have to have a though background check of all purchasers prior to being able to obtain a handgun (ANA, 2016). If a person has any history of instability such as bipolar or mental health condition should not be allowed to purchase any type of gun. I believe the model I picked will help facilitate a change at the federal or state level and hopefully show our government how dangerous gun violence has become. I hope to instill change even if just a little change at first (CDC,20110). Gun purchasing should be harder than what it is . In this day anyone can purchase a gun and for someone to be legal doesn’t take much, someone to vouch for you. It shouldn’t be this easy.
American Academy of Pediatrics, Council on Communications and Media, Media Violence, Pediatrics 2009;124;1495-1503.
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Centers for Disease Control and Prevention, Morbidity and Mortality Weekly Report, 2010, 10 Greatest Public Health Achievements, Retrieved
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6019a5.htm ii S
Identify your selected healthcare policy priority and discuss the rationale for your selection. Describe the model of policy making that you feel would be best applied to your policy issue and the rationale for selecting this model.
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Week 2: Policy-Priority Selection
My selected healthcare policy priority is mandatory human papillomavirus (HPV) vaccination. The rationale for my selection is human papillomavirus (HPV) is the most common sexually transmitted infection in the United States, and some health effects caused by HPV can be prevented by the HPV vaccines. About 79 million Americans are currently infected with HPV, and about 14 million people become newly infected each year (CDC, 2017). I also had a 32 years old female patient that contracted HPV, developed cervical cancer, had a hysterectomy and somehow the cancer came back and spread everywhere to her other organs. I do believe that everyone has a choice to make their own health care decisions; however, the HPV vaccine is recommended for younger children and parents do not always make the right choices being naïve that their children might not be sexually active. In this instance, a decision that has the potential to impact more than one person should be regulated and mandated by the government. Since I have a son, I cannot even imagine how devastated I would be if something like that happened to him when it could all be prevented with one vaccination.
NR 506 Week 2: Policy-Priority Selection
The Longest’s Policy Cycle Model would best apply to my policy and it includes three phases to the policy process: a policy formulation phase, an implementation phase, and a policy modification phase. According to Mason et al. (2016), policy formulation includes all of the activities that are involved in policy design, including those activities which inform the legislators; policy implementation comprises the rule-making phase of policy development where the legislative branch passes the law to the executive branch which is charged with implementation; lastly, policy modification allows all previous decisions to be revisited and modified. I selected this model because it seems straightforward and will guide me step-by-step to help pass my policy.
NR 506 Week 2: Policy-Priority Selection References
Centers for Disease Control and Prevention. (November, 2017). Genital HPV Infection- CDC FactSheet. Human Papillomavirus (HPV). Retrieved from http://www.cdc.gov/std/hpv/stdfact-hpv.htm
Mason, D. J., Gardner, D. B.,Outlaw, F. H., & O’Grady, E. T. (Eds). (20
I have been having a difficult time choosing my healthcare policy priority, mainly because I am worried that it is one that is being talked about by everyone lately. However, with that being said, I have chosen the Opioid Epidemic or the Opioid Overdose Crisis. I have chosen this topic because it specifically has been a problem I have witnessed with patients, and people within surrounding communities. It also is something that could be reduced if laws were different.
According to the National Institute on Drug Abuse (2018), Each day 115 Americans die from opioid overdoses, which means nearly 42,000 people die annually from a preventable cause. I grew up in a town of 1,000 people, so for me to see this amount of people die annually is baffling.
The estimated total “economic burden” for the US each year is $78.5 billion a year, as per The Center for Disease Control and Prevention, (2017). This is said to include the misuse of opioid prescriptions, cost of healthcare, loss of productivity, addiction alone, and the involvement of criminal justice (National Institute on Drug Abuse, 2018).
I think that as far as sources of healthcare policy, this policy would be at the Organizational level, because it would be required to meet FDA requirements, and have multiple organizations involved in decision making as well as including multiple organizations’ data. This would be a public policy.
This topic is important to me, because as nurses we all have a few patients that we say we will never forget. One of these patients for me was a 21 year old. He was admitted for altered mental status and was on a Narcan drip. Once he began to wake up he told us that he had just tried a pill and this is what happened to him. He stated it was his first time, and he had no previous history of drug abuse. The doctor then decided to discharge him this day, and everyone chalked it up to a young college kid making a stupid choice and trying a pill that was given to him.” Not 12 hours later the same young 21 year old ended up in the ER. He was being coded en route to the hospital, and after a long attempt at resuscitation, he did not make it. This patient had access to Fentanyl patches and was apparently cutting them open and eating them. This was a definite eye opening experience for me. There are also been newspaper reports in a surrounding community about five to 10 Narcan kits being used each weekend. It just amazes me that this situation has gotten so out of control over the last several years.
NR 506 Week 2: Policy-Priority Selection References:
National Institute on Drug Abuse. (2018). Opioid overdose crisis. Retrieved from: https://www.drugabuse.gov/drugs-abuse/opioids/opioid-overdose-crisis
The Center for Disease Control and Prevention. (2017). National Vitals Statistics System, Mortality. Retrieved from: https://wonder.cdc.gov
16). Policy & politics in nursing and healthcare (7th ed.). Retrieved from http://online.vitalsource.com
I think that there should be required follow up between the provider and patient once opiods are prescribed. All too often a patient is discharged from the hospital with narcotics and the provider does not do any type of follow up other than refer them to follow up with their primary care provider. I think all providers whether it be inpatient/hospital setting or primary care providers, should be required to follow up with all of their patients who are on prescribed opioids. I also think there should be documented non-opioid treatment attempts on all chronic opioid users as well.
With this being said, I do not think that opioids should not be used for acute patients. For example, if I came into the my physician’s office with a kidney stone or after I threw my back out, I would not expect them to attempt non-pharmacological treatment. In instances like these, a small amount of narcotics should be able to be prescribed, but then the physician should be required to follow up within a given time frame, whether it be 24 hours or a week. I think because the FDA is a federal agency, this should be done by everyone and not just by certain states. Of course, to make a change it’s not easily done at that level, so I think it would have to start slowly. I think I would first propose it to all hospital employed providers at my hospital. After that change was implemented and there was time for adequate data to be obtained, i would branch out to other facilities, and then eventually to the state level.
Many physicians will prescribe a patient a narcotic for an acute pain, but then continue to refill the medication for years “just because.” This contributes to the problem. I worked with a nurse years ago who had back pain and went to her PCP and was prescribed Norco. She became dependent on the Norco, and eventually stole Dilaudid, Morphine, Norco, and many other drugs from the hospital. Of course she was caught and her license was disciplined, but the point is, this prescription started innocent, but due to a lack of follow up from her physician, the medication was continued to feed a habit, which could have been avoided had there been stricter follow up. If the physicians were required to follow up and have documentation that was supportive of their reason for continuing the prescription, the numbers may decrease. At a certain point, the physician could then potentially refer the patient to a pain specialist for some sort of treatment that was not an opioid
I could not agree more with you that opiate overdose has become a major crisis in America. I work in a pediatric Emergency room setting where we have on any given day at least one –two adults dropped off at our door and have overdosed. The majority of individuals who become addicted to drugs stems from one receiving prescriptions for say an injury or after having surgery and these medications although are a potential for addition are needed to help heal (Click et al, 2018). There needs to be a balance between treating a patient’s complaints and in causing harm to the patient can be troublesome (Click et al, 2018). Providers have a responsibility to their patient’s and want to make sure one is not in pain but at the same time should consider potential complications from what and how they prescribe pain medications ( Click et al, 2018). I am unsure of how to fix this and agree it a policy would need to start on the organizational level, but agree that it would require more than that.
Click I., Bohannon, J.M., Anderson, H., & Tudiver, F (2018). Opioid prescribing in rural family
practices: A qualitative study. Substance use and misuse. 55 (4), 533-540.
doi: 10.1080/10826084.2017.1342659
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