D025 Essentials for Advanced Professional Nurse and Professional Roles

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D025 Essentials for Advanced Professional Nurse and Professional Roles

D025 Essentials for Advanced Professional Nurse and Professional Roles

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Essentials for advanced professional nurse and professional roles (D025)
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D025Essentials of Advanced Nursing Roles and Interprofessional Practice
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Advocating for Policy Change to Improve Health Outcomes in the Community

College of Health Professions, Western Governors University D025: Essentials of Advanced Nursing Roles and Interprofessional Practice

Advocating for Policy Change to Improve Health Outcomes in the Community Advocating is the act of using education, experience, and position to speak out and stand up for the rights and services of others. The art of advocacy is taught early on in nursing colleges across the nation and is one of the primary responsibilities of a nurse. In the acute care setting, nurses advocate well ensuring the best possible care for patients, but on a larger scale, advocacy is often lost concerning preventative care in the community. It is the role of an advanced professional nurse to advocate for policy change to improve health outcomes in the community. Advanced Professional Nurse as Advocate There are two significant differences in how an advanced professional nurse advocates for an at-risk population in the community versus how an advanced professional nurse advocates for an individual patient in the clinical practice setting. The first significant difference is the level of care involved in advocacy. An advanced professional nurse advocates for an at- risk population in the community by focusing on preventative care and through policy change. In contrast, an advanced professional nurse advocates for an individual patient in the clinical practice setting by treating acute illness and ensuring the best possible secondary or tertiary care. The focus is on preventative care versus secondary or tertiary care. Another significant difference is who an advanced professional nurse is collaborating with to advocate. In the community, an advanced professional nurse advocates by proposing policy changes and collaborating with local leaders to ensure the policy changes pass through legislation (Nickitas et al., 2018). In the clinical practice setting, an advanced professional nurse advocates by collaborating with the patient’s individual interprofessional team of doctors, nurses, pharmacists, and therapies to ensure the best outcome (Bondurant & Armstrong, 2016). The difference is advocating for an individual versus advocating for an entire community. An advanced professional nurse has a direct impact on each patient when advocating, whereas advocating in

and across the United States at 16% adult smokers (CHR&R, 2021). The data driven health issue in Winnebago County is identified as smoking in adulthood. Characteristics of the at-risk Population The at risk population identified in this analysis is uneducated adults. Two characteristics of uneducated adults stem from childhood including dropping out of high school and growing up in poverty. In Winnebago County, only 88% of adults have obtained a high school diploma compared to 94% across the United States (CHR&R, 2021). In addition, only 59% of adults have completed some college compared to 73% across the United States (CHR&R, 2021). In Winnebago County, 27% of children live in poverty compared to 10% across the United States (CHR&R, 2021). Dropping out of high school and growing up in poverty significantly increases the risk of smoking in adulthood (Gagne et al., 2020). Social Determinant of Health (SDOH) The social determinant of health (SDOH) identified for the health issue of smoking in adulthood is limited education access for children. According to Healthy People 2030 (n.), children living in poverty are more likely to drop out of high school, and dropping out of high school places a child at higher risk for smoking in adulthood. Currently, Winnebago County is filled with uneducated adults related to childhood poverty and dropping out of high school. In order to help prevent the new generation of adults from smoking, it is imperative Winnebago County increase and improve the education access to children. Current Policy Current policy provides limited support to prevent the new generation of adults from smoking, therefore does not adequately address the uneducated adult population or SDOH identified as limited education access for children. Due to the Smoke-Free Illinois Act and the Illinois Clean Indoor Air Act, Winnebago County created the Tobacco Free and Smoke Free Environment Policy (Winnebago County, 2014). This current policy prohibits any tobacco use close to buildings or indoors. This policy addresses current smokers, but does not provide any

preventative measures. As identified above, dropping out of high school and growing up in poverty result in limited education access which leads to increased risk of smoking in adulthood. This current policy does not address the SDOH, therefore, does not adequately address smoking in adulthood. Policy Proposal In order to address the limited education access for children in Winnebago County, a policy to implement an Extended Early Childhood Program is proposed. An Extended Early Childhood Program would increase education access to children in poverty by addressing the daily socioeconomic needs. According to Healthy People 2020 (n.), children in low socioeconomic situations are more likely to require special education and are less likely to graduate high school. By ensuring children living in poverty have the services required to increase and improve education access, high school dropout rates will decrease thus reducing the amount of smokers in the next generation. Health Issue Impact The policy to implement an Extended Early Childhood Program will positively impact the health issue, smoking in adulthood, by directly influencing the social determinant of health, limited education access for children. Extended Early Childhood Programs have been shown to have a positive impact on the physical and mental health of adults (Healthy People 2020, n.). The Carolina Abecedarian Project found that adults who were enrolled in early education programs were less likely to use cigarettes as adults (Healthy People 2020, n.). Overall, increasing access to quality education plays a significant role in positively impacting future health outcomes and community health issues. Equitable Distribution of Resources In order to ensure equitable distribution of resources, the policy proposal will address diversity. The proposed policy will include a diversity clause that clearly states that the Extended Early Childhood Program will not discriminate against race, color, religion, sexual orientation, gender

Policy Maker Jude Makulec, School Board President, is a policy maker in Winnebago County with the authority to move the policy proposal forward. Rationale Jude Makulec was chosen as a key policy maker due to the influential role the School Board President plays in education access and reform. With a direct link to the School Board and Public Schools in Winnebago County, Jude Makulec is a key stakeholder with local connections that will help ensure the policy’s progress. Strategic Next Steps With the aim of strengthening professional practice as a policy advocate, an advanced professional nurse would use the following strategies: engage in collaborative initiatives and expand interprofessional advocacy skills. To engage in collaborative initiatives, an advanced professional nurse should join a nursing advocacy group such as the National League for Nursing or the American Association of Colleges of Nursing to stay up to date on current policy change initiatives across the nation. In addition, it is important to engage in the local community by staying current on local health issues and social determinants, communicating and collaborating with local leaders, and following an advocacy plan to better the health of the community. Continually expanding interprofessional advocacy skills is an essential strategy of the advanced professional nurse. Learning to communicate and collaborate, listen mindfully, and engage in reflective practices is crucial to be an effective advocate. Conclusion By advocating for the health of the community, an advanced professional nurse fulfills one of the primary responsibilities of a nurse as laid out in the American Nurses Association Code of Ethics. It is imperative to engage in the community to stay up to date on the health issues and social determinants of health that impact health outcomes. Through collaboration with local leaders, an advanced professional nurse is able to advocate for policy reform to better

the health outcomes of the community. It is crucial that the nursing community focus on advocacy to not only provide the best possible care for individuals, but for entire communities.

Sims, S., Hewitt, G., & Harris, R. (2015). Evidence of a shared purpose, critical reflection, innovation and leadership in interprofessional healthcare teams: A realist synthesis. Journal of Interprofessional Care , 2 9(3), 209–215. doi/10.3109/13561820.2014. Winnebago County. (2014). Tobacco free and smoke free environment policy. wincoil/media/90326/winnebago_county_tobacco_use_policy_revised_3_ .pdf
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2
Advocating for Policy Change to Improve Health Outcomes in the Community
Advocating is the act of using education, experience, and position to speak out and
stand up for the rights and services of others. The art of advocacy is taught early on in nursing
colleges across the nation and is one of the primary responsibilities of a nurse. In the acute care
setting, nurses advocate well ensuring the best possible care for patients, but on a larger scale,
advocacy is often lost concerning preventative care in the community. It is the role of an
advanced professional nurse to advocate for policy change to improve health outcomes in the
community.
Advanced Professional Nurse as Advocate
There are two significant differences in how an advanced professional nurse advocates
for an at-risk population in the community versus how an advanced professional nurse
advocates for an individual patient in the clinical practice setting. The first significant difference
is the level of care involved in advocacy. An advanced professional nurse advocates for an at-
risk population in the community by focusing on preventative care and through policy change. In
contrast, an advanced professional nurse advocates for an individual patient in the clinical
practice setting by treating acute illness and ensuring the best possible secondary or tertiary
care. The focus is on preventative care versus secondary or tertiary care. Another significant
difference is who an advanced professional nurse is collaborating with to advocate. In the
community, an advanced professional nurse advocates by proposing policy changes and
collaborating with local leaders to ensure the policy changes pass through legislation (Nickitas
et al., 2018). In the clinical practice setting, an advanced professional nurse advocates by
collaborating with the patient’s individual interprofessional team of doctors, nurses, pharmacists,
and therapies to ensure the best outcome (Bondurant & Armstrong, 2016). The difference is
advocating for an individual versus advocating for an entire community. An advanced
professional nurse has a direct impact on each patient when advocating, whereas advocating in
3
the community results in an indirect impact with the goal of improving health outcomes for the
whole.
Interprofessional Collaboration
In order for an advanced professional nurse to advocate on a larger scale, it is important
to collaborate with an Advocacy Action Team (AAT). An AAT is a team of professionals that work
together to speak out and stand up for the rights and services of others. Interprofessional
collaboration is an essential component of an AAT to be efficient and successful. Two evidence-
based strategies to promote interprofessional collaboration include establishing guidelines and a
shared purpose and critically reflecting on the process (Sims et al., 2015). Establishing
guidelines and a shared purpose ensures that roles and responsibilities are well defined, and
that each team member is working towards a clearly set purpose, or end goal (Sims et al.,
2015). A successful AAT works both individually and collaboratively within the guidelines to keep
focus and ensure progress. The guidelines and purpose should be set by the team leader, but
must be agreed upon by each team member. Keeping in mind the “why” behind the goal helps
the AAT to stay focused and continue on, even through resistance and barriers. By critically
reflecting on the progress, the AAT is able to measure what is working and any barriers. This
should be a non-biased review that results in feedback that is usable to change or adapt the
plan as needed. The AAT is then able to develop new, innovative ideas that not only help
overcome barriers, but help to create more efficient processes that potentially decrease the
resources needed and overall time it takes to complete the plan (Sims et al., 2015).
Data Driven Health Issue
According to County Health Rankings and Roadmaps (2021), Winnebago County is
ranked as one of the least healthy counties in Illinois. Currently, adult smokers make up 21% of
the population of Winnebago County (County Health Rankings and Roadmaps [CHR&R], 2021).
This is a significantly higher percentage when compared to the rest of the population of Illinois
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and across the United States at 16% adult smokers (CHR&R, 2021). The data driven health
issue in Winnebago County is identified as smoking in adulthood.
Characteristics of the at-risk Population
The at risk population identified in this analysis is uneducated adults. Two characteristics
of uneducated adults stem from childhood including dropping out of high school and growing up
in poverty. In Winnebago County, only 88% of adults have obtained a high school diploma
compared to 94% across the United States (CHR&R, 2021). In addition, only 59% of adults
have completed some college compared to 73% across the United States (CHR&R, 2021). In
Winnebago County, 27% of children live in poverty compared to 10% across the United States
(CHR&R, 2021). Dropping out of high school and growing up in poverty significantly increases
the risk of smoking in adulthood (Gagne et al., 2020).
Social Determinant of Health (SDOH)
The social determinant of health (SDOH) identified for the health issue of smoking in
adulthood is limited education access for children. According to Healthy People 2030 (n.d.),
children living in poverty are more likely to drop out of high school, and dropping out of high
school places a child at higher risk for smoking in adulthood. Currently, Winnebago County is
filled with uneducated adults related to childhood poverty and dropping out of high school. In
order to help prevent the new generation of adults from smoking, it is imperative Winnebago
County increase and improve the education access to children.
Current Policy
Current policy provides limited support to prevent the new generation of adults from smoking,
therefore does not adequately address the uneducated adult population or SDOH identified as
limited education access for children. Due to the Smoke-Free Illinois Act and the Illinois Clean
Indoor Air Act, Winnebago County created the Tobacco Free and Smoke Free Environment
Policy (Winnebago County, 2014). This current policy prohibits any tobacco use close to
buildings or indoors. This policy addresses current smokers, but does not provide any
5
preventative measures. As identified above, dropping out of high school and growing up in
poverty result in limited education access which leads to increased risk of smoking in adulthood.
This current policy does not address the SDOH, therefore, does not adequately address
smoking in adulthood.
Policy Proposal
In order to address the limited education access for children in Winnebago County, a
policy to implement an Extended Early Childhood Program is proposed. An Extended Early
Childhood Program would increase education access to children in poverty by addressing the
daily socioeconomic needs. According to Healthy People 2020 (n.d.), children in low
socioeconomic situations are more likely to require special education and are less likely to
graduate high school. By ensuring children living in poverty have the services required to
increase and improve education access, high school dropout rates will decrease thus reducing
the amount of smokers in the next generation.
Health Issue Impact
The policy to implement an Extended Early Childhood Program will positively impact the
health issue, smoking in adulthood, by directly influencing the social determinant of health,
limited education access for children. Extended Early Childhood Programs have been shown to
have a positive impact on the physical and mental health of adults (Healthy People 2020, n.d.).
The Carolina Abecedarian Project found that adults who were enrolled in early education
programs were less likely to use cigarettes as adults (Healthy People 2020, n.d.). Overall,
increasing access to quality education plays a significant role in positively impacting future
health outcomes and community health issues.
Equitable Distribution of Resources
In order to ensure equitable distribution of resources, the policy proposal will address diversity.
The proposed policy will include a diversity clause that clearly states that the Extended Early
Childhood Program will not discriminate against race, color, religion, sexual orientation, gender
6
identity, or disability. Also as part of the policy, a diversity board will be in place to monitor the
participants in the program and verify that entrance into the program is based on need, not
favoritism. Part of the responsibilities of the diversity board will be to collect and analyze the
data of applicants. To ensure resources are distributed equally and appropriately, a limited
amount of spaces from each diversity group will be available and filled. In order to be a steward
of the resources available, if there are no applicants from a particular diversity group, the
diversity board would fill the open spaces based on the greatest need.
Ethical Provisions
The policy proposal upholds provision 7 and provision 8 from the American Nurses
Association (ANA) Code of Ethics. Provision 7.3 states that nurses must contribute to the
community by advocating for health initiatives through policy development (American Nurses
Association [ANA], 2015). Provision 8.2 states that nurses have a responsibility to address
social determinants of health by collaborating with leaders and legislators to ensure the
advancement of the health and safety of the population (ANA, 2015). By collaborating with local
leaders and legislators through policy reform and development, the advanced professional
nurse contributes to and advocates for the health of the community. Advocating for a policy to
implement an Extended Early Childhood Program directly impacts the limited education access
for children thus upholding the ANA Code of Ethics.
Barriers
Potential barriers in Winnebago County that could impede the implementation of the
policy proposal include limited financial resources and resistance from key stakeholders.
Winnebago County operates on a limited budget. Implementing an Extended Early Childhood
Program would require significant funding or grants outside of the budget. Resistance from key
stakeholders is likely due to differing opinions and agendas. It is imperative that the policy
leader collaborates with key stakeholders to ensure optimal funding and support from key
stakeholders.
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Policy Maker
Jude Makulec, School Board President, is a policy maker in Winnebago County with the
authority to move the policy proposal forward.
Rationale
Jude Makulec was chosen as a key policy maker due to the influential role the School
Board President plays in education access and reform. With a direct link to the School Board
and Public Schools in Winnebago County, Jude Makulec is a key stakeholder with local
connections that will help ensure the policy’s progress.
Strategic Next Steps
With the aim of strengthening professional practice as a policy advocate, an advanced
professional nurse would use the following strategies: engage in collaborative initiatives and
expand interprofessional advocacy skills. To engage in collaborative initiatives, an advanced
professional nurse should join a nursing advocacy group such as the National League for
Nursing or the American Association of Colleges of Nursing to stay up to date on current policy
change initiatives across the nation. In addition, it is important to engage in the local community
by staying current on local health issues and social determinants, communicating and
collaborating with local leaders, and following an advocacy plan to better the health of the
community. Continually expanding interprofessional advocacy skills is an essential strategy of
the advanced professional nurse. Learning to communicate and collaborate, listen mindfully,
and engage in reflective practices is crucial to be an effective advocate.
Conclusion
By advocating for the health of the community, an advanced professional nurse fulfills
one of the primary responsibilities of a nurse as laid out in the American Nurses Association
Code of Ethics. It is imperative to engage in the community to stay up to date on the health
issues and social determinants of health that impact health outcomes. Through collaboration
with local leaders, an advanced professional nurse is able to advocate for policy reform to better
8
the health outcomes of the community. It is crucial that the nursing community focus on
advocacy to not only provide the best possible care for individuals, but for entire communities.
9
References
American Nurses Association. (2015). Code of ethics for nurses with interpretive statements.
https://www.nursingworld.org/coe-view-only
Bondurant, P.G., & Armstrong, L. (2016). Nurses: Leading change and transforming care –
expert opinion. Newborn & Infant Nursing Reviews, 16(3), 155-160.
https://doi.org/10.1053/j.nainr.2016.07.004
County Health Rankings & Roadmaps. (2021). Winnebago (WB).
https://www.countyhealthrankings.org/app/illinois/2021/rankings/winnebago/county/outco
mes/overall/snapshot
Gagne, T., Frohlich, K.L., & Quesnel-Vallee, A. (2020). The role of education and other
transition milestones in the progression of social inequalities in cigarette smoking
between the ages of 18 and 25: Evidence from the Canadian national population health
survey. Addictive Behaviors, 109. https://doi.org/10.1016/j.addbeh.2020.106476
Healthy People 2020. (n.d.). Early childhood development and education.
https://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-
health/interventions-resources/early-childhood-development-and-education
Healthy People 2030. Education access and quality.
https://health.gov/healthypeople/objectives-and-data/browse-objectives/education-
access-and-quality
Nickitas, D. M., Middaugh, D. J., & Feeg, V. (2018). Policy and politics for nurses and other
health professionals: Advocacy and action (3rd ed.). Jones & Bartlett Learning.
https://ebookcentral.proquest.com/lib/westerngovernors-ebooks/reader.action?
docID=5504726&ppg=25
Why is this page out of focus?
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Sims, S., Hewitt, G., & Harris, R. (2015). Evidence of a shared purpose, critical reflection,
innovation and leadership in interprofessional healthcare teams: A realist synthesis.
Journal of Interprofessional Care, 29(3), 209–215.
https://doi.org/10.3109/13561820.2014.941459
Winnebago County. (2014). Tobacco free and smoke free environment policy.
https://wincoil.us/media/90326/winnebago_county_tobacco_use_policy_revised_3_2014
.pdf
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D025 Essentials for Advanced Professional Nurse and Professional Roles