D025 Task 2 Advocating for Policy Change to Improve Health Outcomes in the Community

D025 Task 2 Advocating for Policy Change to Improve Health Outcomes in the Community

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Western Governors University

D025 Essentials of Advanced Nursing Roles and Interprofessional Practice

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Advanced Professional Nurse as Advocate

Nurses play a vital role in advocating for patients across various settings and situations. According to the American Nurses Association (ANA), advocacy is a foundational pillar of nursing. Nurses instinctively advocate not only for their individual patients but also within their workplaces and communities (American Nurses Association [ANA], n.d.). The scope and focus of advocacy differ depending on the context. An advanced professional nurse advocates on a broader scale, focusing on at-risk populations within the community by identifying key issues affecting these groups and tailoring advocacy efforts accordingly. For example, in a community setting, the nurse uses statistical data and demographic information to drive initiatives such as policy changes or program implementations that benefit the entire at-risk population.

In contrast, when advocating for a patient in a clinical environment, the nurse focuses on specific, individualized goals based on the patient’s unique health history and medical needs. The advocacy in clinical settings revolves around enhancing the well-being and treatment plans of individual patients, requiring personalized knowledge and care strategies.

Interprofessional Collaboration

Healthcare is continually evolving, and nurses now hold critical responsibilities, including policy development, care coordination, healthcare improvement measurement, and implementation of change initiatives (Moss, Seifert, & O’Sullivan, 2016). To successfully implement advocacy plans, an advanced professional nurse must create an Advocacy Action Team (AAT), emphasizing the importance of effective interprofessional collaboration.

Interprofessional collaboration involves diverse health professionals working collectively alongside patients, families, caregivers, and communities to deliver high-quality care (World Health Organization [WHO], 2017). Two key strategies to foster collaboration within the AAT include role-defining and promoting diversity. Role-defining clarifies each team member’s responsibilities and contributions, ensuring a shared understanding of how individual roles synergize to achieve common objectives. Promoting diversity enriches the team with varied perspectives, skills, and expertise, facilitating innovative problem-solving and comprehensive decision-making.

Data-Driven Health Issue

Solano County, located between San Francisco and Sacramento in California, encompasses over 400,000 residents across seven cities: Benicia, Dixon, Fairfield, Rio Vista, Suisun City, Vacaville, and Vallejo. One growing health concern in the county is the rising incidence of sexually transmitted infections (STIs). Between 2012 and 2015, the STI infection rate increased by 13.3%, from 2,098 to 2,430 cases (Solano County Health, 2019). The most prevalent infections are gonorrhea, chlamydia, and syphilis, with gonorrhea showing an alarming 95.5% rise from 2012 to 2016. These trends mirror the statewide increase in STI rates, which rose by over 14% in the same period (Hansen, 2018).

Characteristics of the At-Risk Population

The at-risk population for STIs in Solano County can be characterized primarily by age and race. Individuals aged 20-24 exhibit the highest infection rates, followed closely by adolescents aged 13-19 (Hansen, 2018). Racial disparities are stark: African Americans in Solano County are four to five times more likely to contract chlamydia and six to eleven times more likely to be infected with gonorrhea compared to non-Hispanic Whites (Solano County Health, 2016).

Social Determinant of Health

A significant social determinant contributing to elevated STI rates among the at-risk population is access to and quality of healthcare. While quality healthcare is crucial for all individuals, it remains inaccessible for many, particularly minorities, adolescents, and young adults. Barriers such as high costs and limited availability of providers prevent these groups from receiving timely education, prevention, and treatment services that could curb STI transmission. Addressing this healthcare gap is essential for reversing the upward trend in STI rates.

Current Policy

Presently, no specific policy targets the rising STI rates among youth and minority groups in Solano County. Existing initiatives are broad and focus on improving overall access to quality healthcare for the general population. While these efforts are valuable, they do not address the accelerated STI infection rates in the most vulnerable subgroups. Thus, there is a critical need for targeted policies that specifically address the unique needs of these populations.

Policy Proposal

The proposed policy aims to integrate treatment and education components, focusing on adolescents in middle and high schools. Medical professionals would volunteer their time to provide monthly free screenings, preventive care, and treatment directly within schools. This approach addresses the barrier of healthcare access by delivering quality services where adolescents spend much of their time, eliminating financial and logistical obstacles. Additionally, this aligns with the Healthy People 2030 objective to increase the proportion of adolescents receiving preventive healthcare visits (Healthy People 2030, n.d.).

Health Issue Impact

Education is a cornerstone of this policy. School-based programs would inform students about STIs, symptom recognition, prevention strategies, and treatment options. Encouraging early testing and diagnosis, as highlighted by Dr. Matyas, reduces transmission rates by enabling timely treatment (Hansen, 2018). Furthermore, private conversations with healthcare providers during preventive visits promote autonomy, trust, and openness among adolescents—key factors in effective health interventions (Healthy People 2030, n.d.).

Equitable Distribution of Resources

This policy ensures equitable resource distribution by targeting schools across socioeconomically diverse areas, including both affluent and underserved communities. It also emphasizes recruiting healthcare volunteers from diverse backgrounds that reflect the county’s demographic composition. Such representation can enhance engagement and trust, encouraging adolescents to utilize the available services.

Ethical Provisions

The policy aligns with the American Nurses Association’s Code of Ethics, particularly Provision 3, which mandates that nurses advocate for and protect patients’ rights, health, and safety (American Nurses Association [ANA], 2016). It also supports Provision 8, emphasizing collaboration with other health professionals to promote health equity and reduce disparities.

Barriers

Potential challenges include parental objections to STI education and treatment without explicit consent, which may limit program participation for some adolescents. Additionally, school administrators’ approval is essential for program implementation, and refusal from principals could obstruct the policy’s success.

Policy Makers

The superintendent of Solano County schools, Lizette Estrella-Henderson, holds the authority to advance this policy. As the leader responsible for advocating funding, overseeing school programs, and coordinating school operations, the superintendent can effectively facilitate the implementation and success of the initiative.

Strategic Next Steps

To enhance professional nursing practice as a policy advocate, individualized patient care is essential. Tailoring educational content and healthcare services to meet the distinct needs within the adolescent age group improves learning and retention outcomes, avoiding a “one size fits all” approach. Additionally, obtaining certification as a Public Health Nurse would equip the nurse with specialized knowledge, skills, and resources to address community health issues such as STIs more effectively.

Table: Comparison of Advocacy Approaches by Setting

References

American Nurses Association – Advocacy. (n.d.). https://www.nursingworld.org/practicepolicy/advocacy/

American Nurses Association. (2016). Code of Ethics for Nurses. https://nursing.rutgers.edu/wpcontent/uploads/2019/06/ANA-Code-of-Ethics-for-Nurses.pdf

Hansen, T. R. (2018, February 14). STD rates on the rise in Solano. Daily Republic. https://www.dailyrepublic.com/all-dr-news/solano-news/solano-county/std-rates-on-the-rise-in-solano-state/

Healthy People 2030. (n.d.). Increase the proportion of adolescents who speak privately with a provider during preventive medical visits. https://health.gov/healthypeople/objectives-and-data/browse-objectives/adolescents/increase-proportion-adolescents-who-speak-privately-provider-preventive-medical-visit-ah-02

Moss, E., Seifert, P., & O’Sullivan, A. (2016, September 30). Registered Nurses as Interprofessional Collaborative Partners: Creating Value-Based Outcomes. The Online Journal of Issues in Nursing, 21(3). https://doi.org/10.3912/OJIN.Vol21No03Man04

Solano County Health. (2016, April). Solano County chlamydia and gonorrhea rates. https://www.solanocounty.com/civicax/filebank/blobdload.aspx?BlobID=2617

Solano County Health. (2019, April). Public Health Data. https://www.solanocounty.com/depts/ph/reports.asp

World Health Organization. (2017, March 8). Framework for action on interprofessional education & collaborative practice. http://apps.who.int/iris/bitstream/10665/70185/1/WHO_HRH_HPN_10.3_eng.pdf