Advocacy Through Legislation

Nrs-410 week 4

Advocacy Through Legislation

Nurses often become motivated to change aspects within the larger health care system based on their real-world experience. As such, many nurses take on an advocacy role to influence a change in regulations, policies, and laws that govern the larger health care system.

For this assignment, identify a problem or concern in your state, community, or organization that has the capacity for advocacy through legislation. Research the issue and use the “Advocacy Through Legislation” template to complete this assignment.

You are required to cite to a minimum of three sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

ANSWER

Problem 

Poor communication and ineffective handoff between nurses has led to an increment of poor patient outcomes in most healthcare facilities. In health care facilities, communication is critical, and nurses are the hub of effective communication. It is so because they relay and interpret information between patients, caregivers, family members, and physicians (Salem, 2019). Therefore, nurses’ ability to communicate effectively is imperative in providing the best care and positive patient outcomes. During handoff, nurses should have effective communication because it is at this point that they are transferring patient responsibility to another person. Handoff gives room for continuity of care of a patient during their stay in the hospital. Therefore, poor communication and ineffective handoffs prevent quality care to patients. In the past few years, there has been a rise in medical error problems. Many patients have experienced complications that result from poor communication and handoffs hence these complications.

For instance, patients may overdose or miss procedures that could save their lives because of poor handoffs and communications. It is essential to note that having proper reporting and handoffs is necessary for reducing medical errors like missing surgeries (Mardis et al., 2017). In addition to this, proper handoffs and communications reduce patient hospitalization duration and improve patient outcomes. As a result, there is often job satisfaction of nurses when communication and handoffs are effective. Achieving quality care for patients helps achieve an organization’s vision and goals, hence making them competitive in the market. It is for this reason that poor communication and handoff problems must be addressed.

The idea for addressing solution 

Nurses having effective communication and the best and clear handoffs help build an excellent patient-nurse relationship. As a result, the relationship influences patient health outcomes, leading to shorter hospitalization times for the patient. From this perspective, nurses within various facilities need to develop different plans and strategies that will help change the practices that cause poor communication and ineffective handoffs between them. If we advocate through legislation to help entire health providers and hospitals, we will come with the best ways to communicate and hand over patients to their colleagues. Various measures are applicable in the handing off of patient reports and proper communication between nurses. These ways may include the passage and application of the SBAR communication tool. SBAR is the abbreviation for situation, background, assessment, and recommendation. It is easy to apply a tool that has been structured in a way that can facilitate the accurate transfer of information from one individual to the next.

Health care providers and nurses should advocate for specific action tools that they can use during their handoffs. Doing so ensures that all the necessary information is conveyed and listed. Therefore, it ensures that the overtaking nurse does not miss anything. Enacting a standard tool also the past information is concise, clear, and consistent, and hence the overtaking nurse can understand it without difficulty. Therefore, it is recommendable that hospitals and care providers use legislation to implement the necessary tools. It is so because most individuals often respect legislation rules compared to regular rules. In addition to this, legislation can generalize all the rules and required policies, and hence they will apply to every health care system and hospital. For instance, if the SBAR communication tools are included in the legislation, and various regulations are made for those who do not follow it, care providers will ensure they follow the regulations. They will do this to avoid facing the listed consequences or losing their licenses. Doing so will increase patient outcomes and will increase nurse morale as there will be very minimal errors. However, if a facility employs the tools and expects its nurses to follow them, some nurses may look for other job options and opt for places with minimal to zero rules.

Research the Issue

A handoff between care providers and physicians is a leading factor in the facilitation of care continuity and safe patient care delivery. The handoff from a healthcare provider to another staff or nurse is often vulnerable to communication failures between them. Therefore, effective communication is essential for effective and safe patient care. There are various effects of poor communication during handoffs, and they may include inaccurate patient plans, medical errors, repetitive tests, and patient discharge delays, to mention a few. For this reason, hospitals should imply the use of SBAR as their primary communication tool during handoffs.

Evidence 1

The SBAR communication tool’s application as the primary communication method during nurse handoff is essential because it facilitates concise and accurate patient information from one nurse to the other. This promotes patient-centered care and perfect handling of the patient with minimal errors. Apart from this, the application of SBAR facilitates a nurse’s ability to obtain and remember information about patient medication and care that one could easily forget. Doing so increases the chances of a care provider identifying in advance clinical manifestation of the patient, early discharge, accurate care continuity, and it prevents the patient from developing complications in their hospital stay. SBAR improves and strengthens the accuracy and effectiveness of communication between staff and care providers during their handoffs.

Evidence 2

SBAR facilitates the provision of a structure that helps interact between the receiver and giver of the information. It is essential to the giver because it ensures they formulate their thinking before communicating or pass t to anybody else. On the other hand, the receiver knows what should be done and does not interfere or interrupt the information giver with questions that can later be answered (Alert, 2017). The communication tool can be used in a hospital setting to reduce communication barriers among different departments and staff levels. When a nurse applies the communication tool in a clinical setting, they come up with a recommendation that helps them communicate clearly. The use of SBAR in different states has yielded excellent results in healthcare facilities. For example, its application has reduced the rates of medical errors that have historically caused more complications and more extended hospital stay in patients. Medical errors are avoidable, and the SBAR communication tool’s application is the first step to controlling the problem. A similar tool that was implemented is the SOAP note. SOAP is the abbreviation for subjective, objective, assessment, and plan. It is a documentation method that nurses in health care facilities use to write notes in a patient’s chart and everyone can access it (Podder, Lew & Ghassemzadeh, 2020). The implementation of SOAP has allowed care providers to share and record patient information in a comfortable, systematic, and universal format for them to read. Therefore, the legislation of SBAR will play an essential role in the United States’ States ‘care facilities.

Stakeholder Support

There are various stakeholders who I believe will support this implementation. These may include health care providers and organizational managers. It is essential to remember that nurses’ responsibility is to provide quality and efficient care to patients. The best way to do this is to have effective communication between the care providers. It is so because effective communication is the best way to improve patient outcomes and prevent medical errors.

Stakeholder Supporting 1

The first stakeholder who will support the idea is health care providers. I believe they will support the idea because the legislation of SBAR in the health facilities will help them create a standard metal model around the patient. I have learned that there are different opportunities for us to improve information transfer during patient handoff. Therefore, if this is the first way to see to it that patient information is received and understood during a handoff, there is no reason not to support it. It is the responsibility of health care providers to provide quality care to the patients, which is reason enough to support this idea’s legislation. SBAR facilitates communication between nurses and other caregivers, which help them provide patient-centered care. Having patient-centered care promotes positive patient outcomes and prevents medical errors.

Stakeholder Supporting 2

The second set of stakeholders who will support the legislation of the idea is the organizational managers. Every organization and facility intends to be the best in what they do. Legislation of the SBAR communication tool will facilitate the organizations to be what they want to be. It is the organizational manager’s plan and structure members and the organization’s resources to help achieve their goal. In constant adverse patient outcomes, the organizational managers are accountable to the United States’ department of Health and Human Services. The SBAR provides clear communication between health care providers and prevents the unreliability of constantly thinking and guessing whether the other receiver understands what goes on. As a result, if the legislation happens, there will be increased positive patient outcomes, reduced medical errors, and reduced hospital facilities’ mortality rates. Therefore, the organizational managers will not be answerable to the HHS department as there will not be much to explain to the board.

Stakeholder Opposition

Despite the support from different stakeholders, it is possible to conclude that the legislative process may face challenges and opposing views from other people. These challenges may be the result of people not understanding the implementation and formulation of this idea. With change comes resistance, as not every person in the organization will be willing to change their regular routines.

Stakeholder Opposed 1

Nurses are the first groups of individuals that may not support the implementation and legislation of SBAR communication tool. This may happen more so in facilities that have adequate health care professionals.

It might be impossible for this group of nurses to support the tool’s legislation because they are not enough in the facility; hence, they may experience fatigue. However, I would debate this with them by educating them on the importance of the tool and how their work can be easier if they facilitate proper communication and handoffs. Their work will be easier because patients will not overstay in the hospital and prevent readmission as they receive the right care and treatment.

Stakeholder Opposed 2

The second group of stakeholders who may not support the legislation is the lawmakers. They may see this as a waste of resources and unnecessary implementation in the health facilities. They may not see the importance of making this a law and may not support it during the voting process. They may oppose the law because, according to them, it is unnecessary and a waste of time and resources. However, it will be our responsibility to lay to the lawmakers the advantages of implementing this healthcare tool. We will educate them on what happens if poor communication and ineffective handoffs continue in facilities. It does affect not only the patients but also the general economy of the country. It can be evident where insurance companies will have to pay double for treating a patient who developed complications due to medical errors from poor handoffs.

Financial Incentives/Costs

Over the past decades, there has been a rise in the cost of health care services. In addition to this, there is a prediction that health care costs are likely to double soon. It is so because of the constant increase of health care needs by different people who suffer from the most common lifestyle diseases like hypertension and diabetes (Hibbard & Greene, 2013). As earlier mentioned, poor communication among nurses and care providers is a leading cause of medical errors in facilities during handoffs. Poor communication and ineffective handoffs lead to a more extended hospital stay in patients, which cause the facility to utilize the limited available resources. Therefore, if this is not handled sooner, it will be another reason for health care cost increment in patients.

If poor communication and ineffective handoff continue, health care institutions will use many resources to save patients that they could have released and discharged if they applied proper communication tools like SBAR (Superville, 2017). Without applying this tool, the facility will end up managing the adverse effects of medical errors resulting from poor communication. Managing the errors may be costly than the implementation of the idea. Implementing the SBAR communication tool might not be costly because it will only require the organizational managers to train and educate the employees on the dos and don’ts will be cheaper than that of treating medical error complications. If the tool is not applied, it causes medical errors, which lead to insured patients paying double as the patients overstay in the hospital. It also costs employees a lot of time due to readmission, yet it could have managed by the implementation of this tool.

Legislature: Information Needed and Process for Proposal

In advocacy, it is essential to take part in research via legislation to enhance the proposal’s importance and reasons for implementation. It is so because research helps develop a sturdy case for the policymakers, the public, or the media. The case shows the problem as it is and the proposed solution to the problem.

Senator Patricia C. Bates.

Capitol Office 

State Capitol, Room 3048, Sacramento, CA 95814-4900; (916) 651-4036

District Office

24031 El Toro Road, Suite 201A, Laguna Hills, CA 92653; (949) 598-5850

169 Saxony Road, Suite 103, Encinitas, CA 92024; (760) 642-0809

Steps to present this to the Legislator

The first step will be the presentation of the research data to the senator. Doing this will help explain to her the various reasons why the legislation is necessary to the health care facilities. In addition to this, preparing a concise message will be essential in ensuring that all takeovers happen via the legislative process. Lastly, it would be recommendable to ensure effective communication occurs so that every person present understands why the legislation is necessary.

Legislation process

In case the Legislator decides to introduce the bill, the advocacy will have to take the leading stage in the policymaking process. It will do this with close ties with other legislators who will support the idea and implementation importance. The partnership will lead to others supporting the bill hence its implementation.

Christian Principles and Nursing Advocacy

During the advocacy implementation, servant leadership principles will be applied. The principles will be applied in change advocacy in the patient handoff and practices in health facilities. Jesus, the son of God, is an excellent example of a servant leader. He is considered so because he served every person without discrimination or expectation of any kind from them. He equally interacted with the poor, beggars, and the rich people as He only believed in God for His successes. Jesus focused on humanity and died for our sins to save us from our sinful nature. Jesus was concerned about others’ welfare and during the process, He ended up healing many people to take them out of their misery. From this, the advocacy will focus on bringing change in the lives of patients and nurses without having any expectations. Therefore, the principle will help in including everyone in the community without any discrimination. Jesus’ will be emulated to ensure this happens.

References

Alert, S. E. (2017). Inadequate hand-off communication. Sentinel Event Alert, 58, 1-6. https://pubmed.ncbi.nlm.nih.gov/28914519/

Hibbard, J. H., & Greene, J. (2013). What the evidence shows about patient activation: better health outcomes and care experiences; fewer data on costs. Health affairs, 32(2), 207-214. https://pubmed.ncbi.nlm.nih.gov/23381511/

Mardis, M., Davis, J., Benningfield, B., Elliott, C., Youngstrom, M., Nelson, B., … & Riesenberg, L. A. (2017). Shift-to-shift handoff effects on patient safety and outcomes: a systematic review. American Journal of Medical Quality, 32(1), 34-42. https://pubmed.ncbi.nlm.nih.gov/26518882/

Podder, V., Lew, V., & Ghassemzadeh, S. (2020). SOAP Notes. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK482263/

Salem, M. (2019). An Educational Intervention to Improve the Caregivers’ Understanding of the SBAR Tool used for Patient Handover during Hospital Transfer Processes. Adv Practice Nurs, 4(157), 2.

Superville, J. (2017). Standardizing Nurse-to-Nurse Patient Handoffs in a Correctional Healthcare setting: a Quality Improvement Project to improve end-of-shift Nurse-to-Nurse Communication using the SBAR I-5 Handoff Bundle. https://cdr.lib.unc.edu/concern/dissertations/6108vc416

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