DNP Involvement in Policy Development at the Organizational Level

The creation of healthcare policies hinges on a careful analysis of crucial external factors defining the development of health issues within communities. Health policies appear as a response toward the issues faced by community members and, thus, need to address root causes of the problems that affect the well-being of the target community. At the organizational level of policy creation, the involvement of the Doctorate of Nursing Practice (DNP) is essential since a DNP expert can build a regulatory approach toward shaping the policy, as well as address its intervention. As a result, patient outcomes will improve significantly since the policy will help nurses to cater to the needs of the target demographic.

Problem Statement

The issue of patient safety has been gaining an increasingly large amount of attention recently due to the introduction of electronic health records (EHR) and other approaches based on the use of digital tools into the context of the contemporary nursing environment. However, the existing policies promoting patient safety lack the emphasis on the dangers of electronic tools due to the absence of updates and involvement of DNPs in the development of health policies. Therefore, there is the urgency to modify the existing patient safety culture by promoting patient and nurse education actively with the help of appropriate materials. The latter include innovative tools such as simulations, interactive education systems, and other training strategies to encourage the unceasing development of a knowledge system among patients and nurses alike. As a result, both patients and nurses will be able to control the safety levels, which will help reinforce the efficacy of the existing guidelines and prevent the instances of data leakage within the hospital setting.

The lack of connection between nursing policies that are ostensibly supposed to address the needs of a multicultural community and the actual health concerns within the specified environment demands taking urgent measures. Without a proper focus on the specifics of the target population, policymakers are incapable of producing the regulation that will respond to the existing demand and allow preventing a major health concern respectively. Therefore, there is a need to improve the existing approach toward health policy making by introducing to it the framework that will allow focusing on the unique needs of diverse community members, at the same time providing a comprehensive tool for promoting well-being.

Literature Review

The technological breakthrough that has been taking place over the past few decades and defining the development of nursing seems to have defined both positive and negative trends in nursing. The problem of mismanaging data due to the lack of proper skills and experience among nurses and patients alike seems to be the primary cause of concern and the key subject on which one must focus at present.

The development of a policy that could provide nurses and patients with the education necessary for avoiding the threats associated with the digital environment is crucial. Without a policy that would encourage the consistent acquisition of knowledge and skills. Patients will be permanently exposed to the threat of their personal information being stolen (Perrin et al., 2017). The consistent threat of people’s privacy being violated, in turn, will most likely have an adverse effect on their health. The development of stress that may cause depression and even lead to comorbid issues is highly probable in the specified setting. Therefore, the enhancement of patient safety through the redesign of the existing policies is required (Palojoki, Mäkelä, Lehtonen, & Saranto, 2017). The role that DNPs will play in the development of the specified policies will, in turn, include both consultations and the provision of innovative ideas based on the information retrieved from evidence-based practice.

However, when it comes to determining the role that DNPs will play in the promotion of patient safety, one must mention the ability to address policy intervention as the key power that will affect the success of its implementation. By providing the evidence that informs the choice of an appropriate framework, as well as garnering the support from legislators, a DNP is likely to affect the current situation impressively. A DNP will advance the efficacy of the policy by encouraging patient and nurse education, as well as introducing innovative tools for the evaluation of the policy’s success (Chism, 2017). Furthermore, a DNP can help embrace a wide range of factors that affect the promotion of the proposed policy.

Finally, a DNP can use the principles of the Transformational Leadership framework in accordance with the Health Belief Model to change the target population’s perception of the issue and, thus encourage them to develop appropriate attitudes and behaviors necessary to handle the problem. For instance, a DNP can adopt the Transformational Leadership Model to alter the system of health beliefs and philosophies that define the development of relevant health policies (Moran, Burson, & Conrad, 2016). Although the suggested way of changing the current landscape of nursing is admittedly the most painstaking and lengthy, it also allows for a much more satisfying solution to the problem in question, which is the lack of a patient safety culture in the contemporary nursing environment.

Case Description

A Theoretical Perspective

The case under analysis represents the situation in which a patient’s well-being is jeopardized by the lack of safety within the target healthcare environment. Particularly, nurses are barely capable of managing the patient’s personal data due to the lack of skills for handling digital information and the relevant tools. Consequently, the patient is exposed to the danger of their personal information being stolen. Furthermore, the modern healthcare environment also exposes patients to a range of other threats, including the possibility of a fall in the elderly, the development of nosocomial diseases in patients in the ICU department, and similar problems. The absence of a coherent set of standards and the absence of a comprehensive safety management technique has affected the safety of 238 inpatients’ personal data, as well as 27 instances of a fall in elderly patients and the mismanagement of 11 ICU patients’ needs. Therefore, there is a strong need in enhancing the delivery of care.

To resolve the problem, one will have to adopt the Health Belief Model (HBM). By definition, the proposed framework suggests being able to predict behaviors of target populations and foster the development of specific health habits among them (Jalilian, Motlagh, Solhi, & Gharibnavaz, 2014). Therefore, the adoption of the HBM tool will help to cement crucial skills in patients and nurses alike. The HBM Model suggests changing behaviors and encouraging nurses and patients to accept the suggested strategies by altering individual perceptions through modifying factors. Particularly, the perceived seriousness of a specific disease and the necessity to locate signs and symptoms thereof is shaped by evaluating age-, gender-, culture-, and personality-related characteristics of patients.

The experience of a DNP will serve as the platform for locating the factors that shape patients’ and nurses’ attitude toward safety in a nursing context. By determining paradigms and trends in patients’ and nurses’ behavior, one will be capable of isolating the influences that shape their behaviors and suggesting the modifiers that can be introduced into the nursing environment. As a result, both nurse and patients can be educated about the issue of patient safety. For example, the existing set of guidelines for conducting procedures in the realm of the ICU will allow reducing the threat of patients developing comorbid issues (Sahni et al., 2017). Similarly, clear and concise instructions for managing patients’ personal data, particularly, the use of digital databases, will lead to a drop in information mismanagement among nurses.

The process of securing patients’ personal information will demand an overall enhancement of information management within the facility, as well as reinforcement of the nursing ethics and values. The identified step will be accomplished by defining the myths and prejudices surrounding the issue of digital data management and patient-nurse communication, in general. After the first stage of the HBM Model is completed, the identification of the modifying factors, which involve primarily patients’ education status and nurses’ ability to cope with the increasingly large amount of data, must be performed. The assessment may show that the active promotion of patient education is hindered by a vast number of myths regarding health management among patients. Aggravated by inconsistent communication with nurses, the specified concern may grow out of proportions unless addressed respectively. A DNP may need to consider reinforcing the impact of nursing ethics and the associated values to encourage nurses to engage in a cross-cultural dialogue with patients (Riley, 2015). A DNP will have to apply the principles of the Transformational Leadership framework to motivate nurse and help them focus on the needs of diverse patients.

As soon as the perceived threat, which is the lack of knowledge and skills, is recognized by the target population, cues to action will have to be provided. For nurses, the specified step will involve obtaining the necessary skills and information while attending specially designed courses, whereas for patients, the shift in their attitudes will be marked by treating their health more carefully and recognizing threats whenever they appear. Seeing that the perceived barrier, which is represented by myths among patients and the lack of knowledge and skills among nurses, will be removed from the landscape of the identified nursing environment successfully, the likelihood of developing proper behaviors among nurses and patients alike is highly probable, as the HBM suggests. A DNP, in turn, will supply the information with the help of which the success of the proposed change will be determined, and guidelines for sustaining the designed communication patterns within the specified nursing setting will be created. While introducing change to the realm of nursing is crucial, controlling it is also a necessary task that a DNP will assist in accomplishing.

The application of the Need Theory will also allow improving patient outcomes significantly. Comprising the elements of power, affiliation, and achievement, the proposed framework shows that, to attain the required results, particularly, build a knowledge system for patients and nurses, one will have to consider the need for power and the need for affiliation. For this reason, a DNP will have to empower patients and nurses by providing them, with greater independence in decision-making, as well as offering them a plethora of resources for educating themselves (Wagner, 2018). Furthermore, the communication between patients and nurses will have to be enhanced, which can be accomplished by addressing misunderstandings and misconceptions occurring due to the lack of cross-cultural communication skills and busy schedules of nurses. Therefore, the need for power is linked directly to the need for affiliation in the case under analysis. The assessment of the model’s efficacy can be accomplished by comparing the levels of awareness among patients, the level of skills in nurses, and the target population’s independence before and after the intervention.

Discussion

Although the role of a DNP might seem insignificant in the specified scenario, it, in fact, has a direct and massive effect on shaping and designing a health policy aimed at enhancing patient security. The focus on the educational aspect of the program, which is bound to lead to a rapid decrease in the number of negative patient outcomes, is crucial since it will provide the platform for the continuous improvement of nursing quality. A DNP, in turn, will offer extensive evidence that will prove the presence of the problem and define the factors that lead to its development, the lack of patient-nurse communication being the key issue in the identified situation. Even though the process of institutionalizing the proposed change is fraught with certain difficulties such as reluctance among nurses and patients, it is likely to have a profound effect on recovery rates once a DNP provides the evidence required for building a comprehensive policy.

Case Summary

In the scenario in question, communication issues have led to the mismanagement of patients’ needs, including problems in handling patients’ personal data, preventing comorbid infections in the ICU environment, and failing to address the problem of patient falls. As a result, the number of negative patient outcomes increased along with the average length of stay among the specified population, thus, causing additional health concerns. The mismanagement of information seems to be the primary issue causing the observed problems in the target nursing environment; therefore, the development of a policy aimed at redesigning the existing data management process is due. Particularly, rigid guidelines for nurses to follow in the ICU setting and for preventing falls among the elderly are needed. The specified changes can be handled by introducing a policy aimed at improving the quality of communication and data management consistently and promoting the active education among patients and nurses alike. The case shows quite clearly that there is a direct connection between the creation of a policy and the experience of a DNP since the latter is capable of providing the evidence that will shape the policy significantly. Moreover, a DNP can become the transformational leader that will set the course for the further development of the specified area. Indeed, due to the lack of motivation, both nurses and patients may be reluctant to acquire the necessary knowledge and skills. The use of the transformational Leadership approach, in turn, will help the target demographic top embrace the significance of change and the urgency of the suggested modifications. Thus, with the help of the HBM and the Needs Theory, a DNP will be able to restructure the current nursing setting and create the foundation for positive patient outcomes.

References

Chism, L. A. (2017). The doctor of nursing practice (4th ed.). Burlington, MA: Jones & Bartlett Learning.

Jalilian, F., Motlagh, F. Z., Solhi, M., & Gharibnavaz, H. (2014). Effectiveness of self-management promotion educational program among diabetic patients based on health belief model. Journal of Education and Health Promotion, 3(1), 1-14.

Moran, K. J., Burson, R., & Conrad, D. (2016). The Doctor of Nursing Practice scholarly project (2nd ed.). Burlington, MA: Jones & Bartlett Learning.

Palojoki, S., Mäkelä, M., Lehtonen, L., & Saranto, K. (2017). An analysis of electronic health record–related patient safety incidents. Health Informatics Journal, 23(2), 134-145.

Perrin, K., Ernst, N., Nelson, T., Sawyer, M., Pfoh, E., & Cvach, M. (2017). Effect of a nurse-managed telemetry discontinuation protocol on monitoring duration, alarm frequency, and adverse patient events. Journal of Nursing Care Quality, 32(2), 126-133.

Riley, J. B. (2015). Communication in nursing (8th ed.). New York, NY: Elsevier Health Sciences.

Sahni, N., Biswal, M., Gandhi, K., Kaur, K., Saini, V., & Yaddanapudi, L. N. (2017). Effect of intensive education and training of nurses on ventilator-associated pneumonia and central line-associated bloodstream infection incidence in intensive care unit at a tertiary care center in North India. Indian Journal of Critical Care Medicine: Peer-Reviewed, Official Publication of Indian Society of Critical Care Medicine, 21(11), 779-782.

Wagner, E. A. (2018). Improving patient care outcomes through better delegation – communication between nurses and assistive personnel. Journal of Nursing Care Quality, 33(2), 187-193.