Essay AWM2 TASK 1: ADVOCATING FOR POLICY CHANGE TO IMPROVE HEALTH OUTCOMES IN THE COMMUNITY

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Essay AWM2 TASK 1: ADVOCATING FOR POLICY CHANGE TO IMPROVE HEALTH OUTCOMES IN THE COMMUNITY

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AWM2 TASK 1: ADVOCATING FOR POLICY CHANGE TO IMPROVE HEALTH OUTCOMES IN THE COMMUNITY
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University
Western Governors University
Course
Essentials for advanced professional nurse and professional roles (D025)
Academic year2021/2022

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D025Essentials of Advanced Nursing Roles and Interprofessional Practice
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Christen Alexander-Johnson College of Health Professionals, Western Governors University D025: Essentials of Advanced Nursing Roles & Interpersonal Practice Michelle Miller AWM2 Task 1 D April 2022

A. Advocating as an advanced professional nurse Two Differences in how the advanced professional 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 are community and hospital settings. The community setting is to connect patients to resources such as policy changes. By proclaiming policy changes to legislation throughout different available nursing associations across the country. While some policy changes may remain facility-based, to fit the patient population, others may be enforced in the standard of practice. Another way the professional nurse can advocate for improving social determinants of health such as main health issues affecting the identified at-risk population is through community education and improvement in the community available healthcare system. In the hospital setting the advances, the professional nurse can use expression and advocating to aid in assistance for the at-risk population. Medical staff, nurses in particular can claim policy changes to the proper leadership personnel as they are working closest with patients and can voice their needs. By advocating for an explanation of patient education levels for all procedures and diagnoses, patients will then have a better understanding of risk, benefits, prevention, and aftercare. This may additionally include drawings, handouts, and physical explanations to assist in fully understanding the plan of care and interventions as well as monitoring the patient’s safety at the bedside. B. Interprofessional Collaboration waiting for Advocacy Action Team Two evidenced-based strategies to promote proper and effective collaboration are effective communication and conflict management. Effective communication is active listening and open/welcoming body language with no interruptions. By properly participating during communication times, the speaking and listening parties are acknowledged and feel welcomed. Conflict management is how issues are handled as they arise in the workplace. These issues could be production,

near residential areas and lack a track to walk on or need to be updated or refinished for proper use. The ones that are, are not properly equipped as evidenced by the loss of funding to this particular program. D. Characteristics of the At-Risk population Two characteristics of the identified at-risk population are divorced and/or single parents and adults with minimal leisure time. In both characteristics, it can be assumed that psychosocial stability may vary due to daily stressors, also contributing to burnout and self-neglect with the median age being 36 years old. The rate of single-parent households in Douglas County is 32% while in the state of GA it is 30%. The rate of divorced adults in Douglas County is 12% and separated 2% of the total population. Of the described households, 39% involved children (Douglas County demographics 2022). Divorced and or single parents describe parents/adults that do not have shared responsibility of the household when children are involved full time. The legal system calls this parent the “custodial parent”. Usually, these parents are more responsible for the day-to-day activities of the child(ren) which in turn does not leave much personal leisure time. The lack of shared responsibility is often reflected in the neglect of self-care as the surrounding environment may be stressful to juggle with daily requirements. To add, from experience, this also means doctor’s appointments are likely scheduled on the same day to not too much interfere with pay from work. Doing so could then impact financial availability to commit to programs and medical maintenance. With minimal leisure time, whether the adult is childless or not, the daily responsibilities cannot wait to accommodate travel. Douglas County is a fairly diverse community in the terms of economics, education, and age. It appears that because of this diversity, there is not a wide range of availability in employment such as most jobs in the county are low earning and therefore prompt a need to travel further outside of the county to earn desired wages. As of 2022, 72% of the population are white- collar workers, outside of the community, while 27% were blue-collar, within the community (Douglas

County demographics 2022). It is assumed that those numbers will continue to increase as there are fewer opportunities within Douglas County as the community expands to a more residential area. With an income level ($63,835 for two-parent households vs $49,410 for single-parent households), stress, social support, and transportation time (31 average minutes to the city where most of the county is career employed). Financial instability among adults generally is more likely to be affected by obesity as the lack of spring income limits access to healthier food choices and healthcare. All of which are linked in some aspects of everyday lives. The predisposure of financial instability in a combination of lack of physical activity simply further impedes adults and the affected children to obesity. To add, there may be a risk of lack of access to healthcare as a result as there is at least 15% of the population without coverage (Georgia 2021). Douglas County is located outside of Atlanta, GA, and the culture of traffic is widely known to be difficult at all times of the day. When considering this factor on the return home, in conjunction with the hours of operation for available physical activity centers, it further proves difficulty in the ability to successfully participate in physical activities. Obesity among adults generally is more likely to be affected by financial instability. In addition, this at-risk population could be inherited by the children of those households as habits are usually learned through environmental exposure. Obesity increases the risk of further health complications and conditions such as diabetes, hypertension, hyperlipidemia, and stroke. All of which happen to be part of the list of concerns for health for Douglas County residents. E. How SDOH predisposes the at-risk population Social determinants of health in Douglas County are access to physical activity options within the surrounding neighborhoods. The reason for this is a problem is an environment surrounding our parks and recreation centers not being conducive to the everyday lives of working adults and parents. There are limited sidewalks, parks are flooded when it rains, there is no track surrounding fields, walking trails are covered with debris and rubble from unkept grounds in the environment, the playgrounds do not

My proposed policy is to promote healthier foods at an affordable cost while providing service times in gyms, recreational centers, and park hours that are suitable for working adults with and without children. I will ask that Mayor Robinson allow the policy to be put in place to allow implementation and that she supports the funding needed in the cost of employment for additional hours and or building of parks and physical activity areas within the housing community that also offers childcare of some caliber. This may need to include educational services as well. To financially support, I ask that she allow a review of other programs to adjust needs where able which in turn allows room to fund this policy proposal properly. To review the success of the proposed policy, I suggest a quarterly report starting in the second quarter of the year. This gives time to inform the community of changes and allows adjustment in using the resources provided. a. Describe how the policy proposal could impact the health issue of obesity in Douglas County If the policy proposal is accepted, this will increase the opportunity available for consistent physical activity without being compromised by parental duty, travel time, and or cost of use. A rise in consistent physical activity will then lead to a decline in the rate of obesity. In that quarterly review, health should improve as rates of obesity decrease. It should also show a result of better managed health conditions that were likely developed as a result of obesity such as hypertension, COPD, CVA, etc. b. Discuss how the policy proposal will address diversity in the population to ensure equitable distribution of resources. Diversity in this conversation is purely demographical as the population affected is universal based on the family dynamic. It is known that single-parent households are more likely to struggle financially as responsibilities, physical and financial, are not shared. The policy proposal will address diversity in the population by providing the opportunity to use resources for all and not only those with two-parent households with higher incomes where it is assumed that responsibilities can be dispersed equally.

c. Describe how the policy proposal upholds two provisions from the ANA Code of Ethics (2015) Provision 1: The nurse collaborates with other health professionals and the public to protect human rights, promote health diplomacy, and reduce health disparities. The policy proposal upholds this provision by acknowledging that there is an interdisciplinary measure to be taken to include all representative parties to have a successful outcome. Provision 2: The nurse, through individual and collective effort, establishes, maintains, and improves the ethical environment of the work setting and conditions of employment that are conducive to safe, quality healthcare. The policy proposal upholds this provision by alerting and acknowledging that the changes made may also apply to those introducing the change, allowing the change, and implementing the change. Just as any policy change, this could positively affect the community as a whole rather than only those it benefits. d. Describe two actual or potential barriers in your country or state that impede the implementation of the policy proposal A potential barrier to the proposed policy is the availability of demands due to funding. An actual barrier is a time and time it takes to travel from the highway to residential areas within the county. This also impedes the availability of facilities due to closing times. H. Policy Maker Mayor Rochelle Robinson is the chosen policymaker for this assignment. Mrs. Robinson has the ability as Mayor to provide insight into budget planning and municipal structures; both of which may intertwine goals within the community. With the supported belief of the Mayor of Douglasville, GA there can be changes to the communities health disparities by shaping rules and regulations throughout Douglas County health care. I. Two Strategies to strengthen professional practice as a policy advocate

Centers for Disease Control and Prevention. (2021, March 9). Policy Resources to support SDOH. Social Determinants of Health: Know What Affects Health. cdc/socialdeterminants/policy/index.htm

Cullati, S., Bochatay, N., Maître, F., Laroche, T., Muller-Juge, V., Blondon, K. S., Junod Perron, N., Bajwa, N. M., Viet Vu, N., Kim, S., Savoldelli, G. L., Hudelson, P., Chopard, P., & Nendaz, M. R. (2019, February 26). When team conflicts threaten the quality of care: A study of health care professionals’ experiences and perceptions. Mayo Clinic proceedings. Innovations, quality & outcomes. ncbi.nlm.nih/pmc/articles/PMC6408685/

Douglas County demographics. Point2. (2022). point2homes/US/Neighborhood/GA/Douglas-County-Demographics.html

Nsiah, C., Saikwa, M., & Ninnoni, J. P. K. (2019, May 29). Registered Nurses’ description of patient advocacy in the clinical setting. doi/10.1002/nop2.307.

O’Daniel, M. (n.). Professional Communication and Team Collaboration. Patient Safety and Quality: An Evidence-Based Handbook for Nurses. ncbi.nlm.nih/books/NBK2637/

University of Wisconsin Population Health Institute: School of Medicine and Public Health. (2021). Douglas County. County Health Rankings & Roadmaps. countyhealthrankings/app/georgia/2021/rankings/douglas/county/outcomes/o verall/snapshot

US Department of Health and Human Services. (2014, October 27). Healthy places. Centers for Disease Control and Prevention. cdc/healthyplaces/healthtopics/parks.htm
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A. Advocating as an advanced professional nurse
Two Differences in how the advanced professional 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 are community and hospital settings. The community setting is to connect patients to
resources such as policy changes. By proclaiming policy changes to legislation throughout different
available nursing associations across the country. While some policy changes may remain facility-based,
to fit the patient population, others may be enforced in the standard of practice. Another way the
professional nurse can advocate for improving social determinants of health such as main health issues
affecting the identified at-risk population is through community education and improvement in the
community available healthcare system.
In the hospital setting the advances, the professional nurse can use expression and advocating to aid
in assistance for the at-risk population. Medical staff, nurses in particular can claim policy changes to the
proper leadership personnel as they are working closest with patients and can voice their needs. By
advocating for an explanation of patient education levels for all procedures and diagnoses, patients will
then have a better understanding of risk, benefits, prevention, and aftercare. This may additionally
include drawings, handouts, and physical explanations to assist in fully understanding the plan of care
and interventions as well as monitoring the patient’s safety at the bedside.
B. Interprofessional Collaboration waiting for Advocacy Action Team
Two evidenced-based strategies to promote proper and effective collaboration are effective
communication and conflict management. Effective communication is active listening and
open/welcoming body language with no interruptions. By properly participating during communication
times, the speaking and listening parties are acknowledged and feel welcomed. Conflict management is
how issues are handled as they arise in the workplace. These issues could be production,
communication, the management, or anything else that would overall affect the outcome of policy goals.
Whether or not conflict management is successful will affect productivity and growth opportunities.
When conflict resolution is not successful, hostile environments are formed creating a stressful and
gloomed workplace.
C. Data-Driven Health Issue of Douglas County, GA
The health issue in Douglass County, GA is obesity as evidenced by there being a rate of 34% in
the county versus 32% in the state of GA. This is also evidenced by the rate of physical inactivity being
only 25% in Douglas County versus 26% in the entire state of GA. This health problem in Douglas County
GA is supported by the CDC when stating on the listed website that there is a need for open trails,
sidewalks, and parks closer to residential areas. This site also has links listing community meeting
offerings and health impact assessments. These meetings are an open forum for community members to
give concerns and suggestions for improvement in the community for a variety of project needs. The
concern for most community members at this time is the availability of community resources and the
times that these meetings are held. They range from 5 pm to 8 pm on various days and the majority of
resourced facilities close by 5 pm. These times are not suitable for the working adult but are the times
available for accommodation.
The Healthy Community Design Initiative, also known as the Built Environment and Health
Initiative in Douglas county, is no longer a funded program and therefore doesn’t allow for expansion or
rebuilding of the parks and recreation of the community. This means not being able to use the resources
that should be available.
As stated on the website, having access to places for physical activity, such as parks and trails,
encourages community residents to participate in physical activity and do so more often. The closer you
live to a park, the more likely you are to walk or bike to those places and use the park for exercise. This is
not an option for Douglas County residents as most of the parks, gyms, and recreational centers, are not
Why is this page out of focus?
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near residential areas and lack a track to walk on or need to be updated or refinished for proper use. The
ones that are, are not properly equipped as evidenced by the loss of funding to this particular program.
D. Characteristics of the At-Risk population
Two characteristics of the identified at-risk population are divorced and/or single parents and
adults with minimal leisure time. In both characteristics, it can be assumed that psychosocial stability
may vary due to daily stressors, also contributing to burnout and self-neglect with the median age being
36 years old. The rate of single-parent households in Douglas County is 32% while in the state of GA it is
30%. The rate of divorced adults in Douglas County is 12.85% and separated 2.51% of the total
population. Of the described households, 39.03% involved children (Douglas County demographics
2022).
Divorced and or single parents describe parents/adults that do not have shared responsibility of
the household when children are involved full time. The legal system calls this parent the “custodial
parent”. Usually, these parents are more responsible for the day-to-day activities of the child(ren) which
in turn does not leave much personal leisure time. The lack of shared responsibility is often reflected in
the neglect of self-care as the surrounding environment may be stressful to juggle with daily
requirements. To add, from experience, this also means doctor’s appointments are likely scheduled on
the same day to not too much interfere with pay from work. Doing so could then impact financial
availability to commit to programs and medical maintenance.
With minimal leisure time, whether the adult is childless or not, the daily responsibilities cannot
wait to accommodate travel. Douglas County is a fairly diverse community in the terms of economics,
education, and age. It appears that because of this diversity, there is not a wide range of availability in
employment such as most jobs in the county are low earning and therefore prompt a need to travel
further outside of the county to earn desired wages. As of 2022, 72.54% of the population are white-
collar workers, outside of the community, while 27.46% were blue-collar, within the community (Douglas
County demographics 2022). It is assumed that those numbers will continue to increase as there are
fewer opportunities within Douglas County as the community expands to a more residential area. With
an income level ($63,835 for two-parent households vs $49,410 for single-parent households), stress,
social support, and transportation time (31.1 average minutes to the city where most of the county is
career employed). Financial instability among adults generally is more likely to be affected by obesity as
the lack of spring income limits access to healthier food choices and healthcare. All of which are linked in
some aspects of everyday lives.
The predisposure of financial instability in a combination of lack of physical activity simply
further impedes adults and the affected children to obesity. To add, there may be a risk of lack of access
to healthcare as a result as there is at least 15% of the population without coverage (Georgia 2021).
Douglas County is located outside of Atlanta, GA, and the culture of traffic is widely known to be
difficult at all times of the day. When considering this factor on the return home, in conjunction with the
hours of operation for available physical activity centers, it further proves difficulty in the ability to
successfully participate in physical activities. Obesity among adults generally is more likely to be affected
by financial instability. In addition, this at-risk population could be inherited by the children of those
households as habits are usually learned through environmental exposure. Obesity increases the risk of
further health complications and conditions such as diabetes, hypertension, hyperlipidemia, and stroke.
All of which happen to be part of the list of concerns for health for Douglas County residents.
E. How SDOH predisposes the at-risk population
Social determinants of health in Douglas County are access to physical activity options within the
surrounding neighborhoods. The reason for this is a problem is an environment surrounding our parks
and recreation centers not being conducive to the everyday lives of working adults and parents. There
are limited sidewalks, parks are flooded when it rains, there is no track surrounding fields, walking trails
are covered with debris and rubble from unkept grounds in the environment, the playgrounds do not
have working equipment consistently, gyms close at the end of the business day and are mostly utilized
by a stay at home/unemployed and of age students out of school. This problem can be corrected by
revisiting budgeting for the Health Impact plan to put in place routine maintenance to support these
needs in the community. Budgeting was previously cut and as a result, the community is suffering.
Routine maintenance would be grounds keeping further than trash pick up. It would include trimming
and treating the fields and surrounding shrubs, maintaining proper lighting or safety, paving a track to
walk, placing stone or pavement on walking trails, paving sidewalks along the streets, equipment
maintenance when there is an issue at the playground, allowing gyms to stay open and open up an
additional hour to accommodate those traveling from outside of Douglas County for work.
F. Is the current policy insufficient to address SDOH
The current policy is the Health Impact in 5 years plan. This policy states that interventions that
address the conditions in the places where we live, learn, work, and play have the greatest potential
impact on our health. The current policies for childcare and activity facilities such as costs of use,
operation hours for business, and location of business are not only problematic for the population of
concern but also could pose a risk of loss of participation. The loss of participation then leads to a lack in
the use of a business.
This is supported by the Health Impact Assessment which reports community-wide
improvement or worsening every 5 years as well as whether or not it is cost-effective or not based on
interventions applied. Although these interventions are ideal, they are insufficient without the funding
that has been cut for the program designed to support it. The Health Impact in 5yrs is insufficient mainly
because it Is non-clinical. The approach is evidence reporting and cost-saving with the hope of positive
results within 5 years of implementation. This does not address obesity properly as there is no clear plan
to address obesity directly.
G. Policy proposal
Why is this page out of focus?
This is a Premium document. Become Premium to read the whole document.
My proposed policy is to promote healthier foods at an affordable cost while providing service
times in gyms, recreational centers, and park hours that are suitable for working adults with and without
children. I will ask that Mayor Robinson allow the policy to be put in place to allow implementation and
that she supports the funding needed in the cost of employment for additional hours and or building of
parks and physical activity areas within the housing community that also offers childcare of some caliber.
This may need to include educational services as well. To financially support, I ask that she allow a review
of other programs to adjust needs where able which in turn allows room to fund this policy proposal
properly. To review the success of the proposed policy, I suggest a quarterly report starting in the second
quarter of the year. This gives time to inform the community of changes and allows adjustment in using
the resources provided.
a. Describe how the policy proposal could impact the health issue of obesity in Douglas
County
If the policy proposal is accepted, this will increase the opportunity available for consistent physical
activity without being compromised by parental duty, travel time, and or cost of use. A rise in consistent
physical activity will then lead to a decline in the rate of obesity. In that quarterly review, health should
improve as rates of obesity decrease. It should also show a result of better managed health conditions
that were likely developed as a result of obesity such as hypertension, COPD, CVA, etc.
b. Discuss how the policy proposal will address diversity in the population to ensure
equitable distribution of resources.
Diversity in this conversation is purely demographical as the population affected is universal based on
the family dynamic. It is known that single-parent households are more likely to struggle financially as
responsibilities, physical and financial, are not shared. The policy proposal will address diversity in the
population by providing the opportunity to use resources for all and not only those with two-parent
households with higher incomes where it is assumed that responsibilities can be dispersed equally.
c. Describe how the policy proposal upholds two provisions from the ANA Code of Ethics
(2015)
Provision 1: The nurse collaborates with other health professionals and the public to protect human
rights, promote health diplomacy, and reduce health disparities. The policy proposal upholds this
provision by acknowledging that there is an interdisciplinary measure to be taken to include all
representative parties to have a successful outcome.
Provision 2: The nurse, through individual and collective effort, establishes, maintains, and improves the
ethical environment of the work setting and conditions of employment that are conducive to safe,
quality healthcare. The policy proposal upholds this provision by alerting and acknowledging that the
changes made may also apply to those introducing the change, allowing the change, and implementing
the change. Just as any policy change, this could positively affect the community as a whole rather than
only those it benefits.
d. Describe two actual or potential barriers in your country or state that impede the
implementation of the policy proposal
A potential barrier to the proposed policy is the availability of demands due to funding. An actual barrier
is a time and time it takes to travel from the highway to residential areas within the county. This also
impedes the availability of facilities due to closing times.
H. Policy Maker
Mayor Rochelle Robinson is the chosen policymaker for this assignment. Mrs. Robinson has the
ability as Mayor to provide insight into budget planning and municipal structures; both of which may
intertwine goals within the community. With the supported belief of the Mayor of Douglasville, GA
there can be changes to the communities health disparities by shaping rules and regulations throughout
Douglas County health care.
I. Two Strategies to strengthen professional practice as a policy advocate
As an advanced professional nurse, I will continue to further educate my patients and staff on
options available by providing resources while also maintaining dignity and respect within the nurse-
patient relationship. I feel these are benefits applicable to strengthening my professional practice by
building a trustworthy rapport within my advocated community. By providing education, those educated
properly are more likely to be successful in their healthcare management and services provided through
prevention or maintenance. When being intentional about maintaining the dignity and respect of the
population, is an effort to promote confidence in self-care and self-pride in advocacy. While conducting
research for Douglas County, GA, I discovered that even as a nurse, with no political background, I can
still play a part in the conduction of new policies within the community. This is possible as a nurse by
being able to I’ve medical insight into the proper legislative roles to implement the desired change.
J. SBAR summary (ATTACHMENT)
References
American Nurses Association. (2015). American Nurses Association Code of Ethics for Nurses. Silver
Spring, MD.
Why is this page out of focus?
This is a Premium document. Become Premium to read the whole document.
Centers for Disease Control and Prevention. (2021, March 9). Policy Resources to support SDOH.
Social Determinants of Health: Know What Affects Health.
https://www.cdc.gov/socialdeterminants/policy/index.htm
Cullati, S., Bochatay, N., Maître, F., Laroche, T., Muller-Juge, V., Blondon, K. S., Junod Perron, N.,
Bajwa, N. M., Viet Vu, N., Kim, S., Savoldelli, G. L., Hudelson, P., Chopard, P., & Nendaz, M.
R. (2019, February 26). When team conflicts threaten the quality of care: A study of health care
professionals’ experiences and perceptions. Mayo Clinic proceedings. Innovations, quality &
outcomes. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6408685/
Douglas County demographics. Point2. (2022).
https://www.point2homes.com/US/Neighborhood/GA/Douglas-County-Demographics.html
Nsiah, C., Saikwa, M., & Ninnoni, J. P. K. (2019, May 29). Registered Nurses’ description of
patient advocacy in the clinical setting. https://doi.org/10.1002/nop2.307.
O’Daniel, M. (n.d.). Professional Communication and Team Collaboration. Patient Safety and Quality:
An Evidence-Based Handbook for Nurses. https://www.ncbi.nlm.nih.gov/books/NBK2637/
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Essay AWM2 TASK 1: ADVOCATING FOR POLICY CHANGE TO IMPROVE HEALTH OUTCOMES IN THE COMMUNITY