Module 4: Assignment

Assignment:

Each assignment must contain an INTRODUCTION and CONCLUSION page. Make sure you follow the Grading Rubrics to write the homework. Each paragraph must have at least 2-3 in-text APA citation from the References list.

Learning Materials

•             Curley, A. L. C., & Vitale, P. A. (2016). Population-based nursing: Competencies and concepts for advanced practice (2nd ed.). Springer Publishing. Read Chapters 6-7.

•             Montgomery, T., (2012) Health care and politics making your voice heard. Nursing for Women’s Health. 16(3), 198-201.

•             Kimball, R., & Wissner, M. (2015) Religion, poverty, and politics: Their impact on women’s reproductive health outcomes. Public Health Nursing, April 16(10).

•             Montgomery, T.M., Folken, L., & Seitz, M.A. (2014) Addressing adolescent pregnancy with legislation. Nursing for Women’s Health, 18(4), 277-283.

Additional Resources

•             Columbia University. (2011, April 11). Protecting the public’s health through the effective US and global health policy. [Video] YouTube.

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Assignment:

Public health officials in state offices usually participate in the analysis of proposed legislation but may have different names for the format or process used in that state. For this assignment, the term Health Policy Analysis (HPA) will be used with the following format. The student is to create an HPA using one of the following scenarios.

Scenario One:

The nurse consultant in the state office has been assigned to complete the HPA for this bill.

Complete the HPA in clear, succinct sentences. At least three references should be cited using the APA style.

House Bill No. 240 has been introduced in the state General Assembly by a patron and referred to the “Health Committee.” The bill is as follows:

That the code of this state is amended by adding a section to the ɠ 32.1-134 regarding hospital practice to read: Every hospital providing maternity care shall, before releasing each maternity patient, make available to such patient and her husband information about postpartum depression and a list of available treatment options available in the state. This information shall be discussed with the maternity patient with her physician and documented in the patient’s medical record.

Complete a health policy analysis using the following questions:

•             Summarize the proposed legislation. Use your own words to describe the intent of the legislation.

•             Describe the problem the proposed legislation is intended to address. Use secondary data to describe the problem further, as is known from the literature.

•             Identify the stakeholders and project the expected opinion. Indicate who would be in support of the legislation and why. Indicate who would not support the legislation and why?

•             Examine the risks and benefits of the proposed legislation. If this bill is passed, what would be the expected outcomes, and would that positively or negatively impact public health? If this bill is not passed, what would be the positive or negative outcomes?

•             Provide discussion as to the projected costs of this legislation, if any.

•             What would be the recommendation to the Governor?

•             Should the Governor strongly support the bill and make a statement that he would sign if passed by the legislature?

•             Should the Governor support the bill but express concerns or reservations? If so, what are those concerns? Can the proposed legislation be improved? If so, suggest the amendment/s.

•             Should the Governor not support and state that he would veto if it passed the legislature? Give the reasons why the bill should not be supported and vetoed.

Scenario Two:

The student is to search for a state regulation regarding hospitals, choose a section/subject area, and complete an HPA.

•             Give the location using the correct nomenclature.

•             Summarize the hospital regulation. Use your own words to describe the intent of the regulation.

•             Describe the problem/public issue the regulation is intended to address. Use secondary data to describe the problem/issue further, as is known from the literature.

•             Identify the stakeholders and project the expected opinion. Indicate who was probably in support of the regulation and why. Indicate who probably opposed this regulation and why?

•             Examine the risks and benefits of this regulation. If this regulation could be changed, what would be the expected outcomes, and would that positively or negatively impact public health. If this regulation remains, what would be the positive or negative outcomes?

•             Is this regulation a financial burden for hospitals? If so, provide a discussion as to what those costs are associated with this regulation.

•             Should there be some changes in this regulation? If so, why? What would be that process?

Assignment Expectations

Length: 1500 –2000 words; answers must thoroughly address the issues in a clear, concise manner.

Structure: Include a title page and reference page in APA style. These do not count towards the minimum word count for this assignment.

References: Use the appropriate APA style in-text citations and references for all resources utilized to answer the questions. Include at least two (2) scholarly sources to support your claims.

Format: Save your assignment as a Microsoft Word document (.doc or .docx).

File name: Name your saved file according to your first initial, last name, and the assignment number (for example, “RHall Assignment 1.docx”)

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Criteria

Does Not Meet 0%

Approaches 70%

Meets 80%

Exceeds 100%

Criterion Score

Content Weight: 30%

0 points

Topic is inappropriate to assignment, inaccurate understanding of concepts, unclear and difficult to understand; does not address many assignment requirements. Information has weak or no connection to the assignment topic.

21 points

Topic is mostly covered and appropriate to assignment, but does not adequately demonstrate accurate understanding of concepts; mostly clear and understandable; lacks some of the requirements of the assignment description and/or provides little detail; Information relates to the main topic, but few details and/or examples are given.

24 points

Topic is covered completely and appropriate to assignment; overview of key concept dimensions is evident; clear and understandable; addresses all of the requirements of the assignment description, with adequate attention to detail.

30 points

In-depth coverage of topic; outstanding clarity and explanation of concepts demonstrated in information presented; approaches assignment with depth and breadth, without redundancy, using clear and focused details.

Score of Content Weight: 30%,/ 30

Organization Weight: 25%

0 points

Organization is confusing and interferes with reader’s ability to follow ideas.  Weak or no introduction of topic or purpose is unclear, weak, or missing. Conclusion lacks a summary of topic, or is missing or irrelevant.

17.5 points

Ideas are sometimes disorganized or irrelevant; Flow is sometimes choppy; somewhat clear organization. Basic introduction that states topic but is presented in an uninteresting way. Conclusion contains basic summary of topic without final concluding ideas, may inappropriately introduces new information.

20 points

Structures ideas in a coherent, organized order that has good flow and an obvious framework.  Proficient introduction that is interesting and states topic.  Conclusion contains good summary of topic with credible concluding ideas and introduces no new information.

25 points

Exceptionally clear, logical, mature, and thorough organization permitting smooth flow of ideas; Introduction that grabs interest of reader and states topic in clear, unambiguous terms.  Excellent concluding summary with succinct and precise ideas that impact reader.

Score of Organization Weight: 25%,/ 25

Logic/Argument Weight: 15%

0 points

Demonstrates little logical reasoning for the claims and thoughts within assignment; Many claims are weak or illogical.

10.5 points

Lacks some logical reasoning for the claims and thoughts within the assignment; Some claims are weak.

12 points

Uses solid logical reasoning for the claims and thoughts within the assignment.

15 points

Provides exemplary logical reasoning for the claims and thoughts within the assignment.

Score of Logic/Argument Weight: 15%,/ 15

Support Weight: 20%

0 points

Lacks support; Uses poor sources for references; Citations lack credibility, relevance, or academic quality or are not current; Does not meet the minimum number of required citations in assignment description.  APA format and style are not evident.

14 points

Provides weak support or not enough support; Citations are not consistently credible, current, relevant or academic; Meets the minimum number of required citations in assignment description   Missing APA elements; in-text citations, where necessary, are used but formatted inaccurately and not referenced.

16 points

Provides sufficient support with credible, current, relevant academic citations; Meets the minimum number of required citations in assignment description. ; In-text citations and a reference page are present with few format errors. Mechanics of writing are reflective of APA style.

20 points

Provides very strong support from credible, current, relevant, academic citations; Meets or exceeds the minimum number of required citations in assignment description.  Accurate citations and references are presented. No APA errors are evident.

Score of Support Weight: 20%,/ 20

Quality of Written Communication Weight: 10%

0 points

Style and voice inappropriate or do not address given audience, purpose, etc. Word choice is excessively redundant, clichéd, and unspecific. Inconsistent grammar, spelling, punctuation, and paragraphing. Surface errors are pervasive enough that they impede communication of meaning.

7 points

Style and voice are somewhat appropriate to given audience and purpose. Word choice is often unspecific, generic, redundant, and clichéd. Repetitive mechanical errors distract the reader. Inconsistencies in language, sentence structure, and/or word choice are present.

8 points

Style and voice are appropriate to the given audience and purpose. Word choice is specific and purposeful, and somewhat varied throughout. Minimal mechanical or typographical errors are present, but are not overly distracting to the reader. Correct sentence structure and audience-appropriate language are used.

10 points

Style and voice are not only appropriate to the given audience and purpose, but also show originality and creativity. Word choice is specific, purposeful, dynamic and varied. Free of mechanical and typographical errors. A variety of sentence structures and effective figures of speech are used. Writer is clearly in command of standard, written, academic English.

Score of Quality of Written Communication Weight: 10%,/ 10

Rubric Total ScoreTotal

/ 100

Overall Score

Overall Score

Level 10 points minimum

Level 270 points minimum

Level 380 points minimum

Level 4100 points minimum

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Health Policy Analysis

Involvement in the health policy analysis process requires more understanding of an individual patient’s needs. As a result, a sound and solid environmental policy protect people’s health and stewards of available natural resources. Public Health Policy refers to creating conditional systems and science intended to promote health, encourage healthy behavior, prevent injuries, and foster enabling environments between providers and patients across an entire population. According to Langlois et al. (2019), the need to strengthen health policy analyses and systems is inevitable. Public health laws, statutes, and policies help communities, and state authorities promote health, prevent illness, and protect from threats to a healthy population. Besides the numerous functions undertaken by public health officials, such as communicating public health crucial information, they are often involved in proposed legislation analysis (Molnar et al., 2016). This paper intends to complete proposed health legislation (House Bill No. 240) introduced in the state General Assembly regarding maternity health.

Proposed Legislation Summary

Owing to hospital dynamicity practices, state codes can be amended or more legislation proposed to improve hospital-based practices. As healthcare providers work in different practices and departments in hospitals, specific concepts and competencies can be introduced through existing statute amendments or new legislation (Curley, 2016). Consequently, this helps to promote consistency, reduce medical errors and improve patient and staff safety. By laying out advanced procedural practices, public health providers can manage and mitigate risks alongside improving overall quality and performance. In this case, the proposed legislation centers on maternity health.

Conferring to Andres et al. (2016), integrating postpartum maternal and child health benefits the husband extensively. The proposed state code amended by adding a section to the 32.1-134 requires health professionals in this line of work to educate the mother and the husband about postpartum depression. Further, the statute necessitates the need to list available and effective treatment options for the stated condition. Postpartum depression has become a prevalent health issue, and therefore incorporating such practices is enormously significant. Discussion documentation between the maternity patient and her physician can be helpful in future referrals.

Describe the Problem Addressed

Postpartum depression is a condition often associated with recently delivered mothers. Due to postnatal depression, psychological adjustment to motherhood, hormonal changes, and fatigue, the mother can suffer after delivery depression. Interestingly, both postpartum and postnatal depression can severely affect the husband, who also can develop stress culminating in depression: according to Andres et al. (2016). Postpartum Depression (PPD) affects approximately 13-19% of postpartum mothers yearly, with symptoms lasting up to a year. Notably, the depressive disorder severity ranges from minimal depression to severe conditions resultant to suicide (Curley, 2016). Some common signs and symptoms include insecurity, difficulty bonding with baby, insomnia, appetite loss, intense irritability, low self-esteem, and suicidal thoughts. Postpartum and postnatal depression should be promptly diagnosed, treated, and ultimately prevented since their effects extend to the husband. Lifelong implications necessitate evidence-based research to examine causative factors for effective treatment. Accordingly, treatment is issued based on the condition’s severity, including hormone therapy, counseling, and antidepressants.

Stakeholder and Project Expectation

In general, stakeholders are either individuals or groups interested in a given decision or organizational activity. In the healthcare system setting, stakeholders are entities incorporated into healthcare activities. Therefore, they can be impacted by reforms introduced into the healthcare systems (Vélez et al., 2020). Stakeholders play a significant role in the health policy analysis process. Therefore, recognizing these participants alongside the projected opinion helps to formulate inclusive and comprehensive legislation. Vélez et al. (2020) indicates that involving stakeholders in policy-making ensures the successful adoption of evidence-based practices. Additionally, they support projects and other endeavors by supplying the needed skills, resources, and knowledge.

In this case, the major stakeholders are patients, employers, physicians, pharmaceutical firms, insurance companies, and governments. Evidently, all stakeholders identified in this case are expected to agree and support the proposed legislation (Curley, 2016). Given the social, political, and economic impact of postpartum depression, there are enough reasons to support the legislation. For instance, the maternal patient can significantly benefit together with their newborn and family. Physicians can have more time to attend to critical situations while exercising effective case management practices. Pharmaceutical firms and insurance companies can be actively involved, while governments can focus on other population illness incidences.

 Examine Risks and Benefits

Proposed legislation in any sector or industry poses risks and offers benefits; thus, with demerits come merits. If the proposed Bill is passed during the health policy analysis process, anticipated outcomes will positively impact the health sector. Langlois et al. (2019) emphasize that proposed legislation could affect the healthcare system negatively if not correctly implemented or fail to perform in-depth research and analysis. For instance, when legislative risks are not substantially addressed at the initial formulation stage, dramatic impacts could be incurred. If maternity care legislation is passed, the following are the potential risks: patient’s right to disregard, medication management, privacy and confidentiality, antitrust issues, environmental safety, and participant’s Medicare conditions (Molnar et al., 2016). On average, legislation intends to build strong relationships between people and protect the communities by outlining acceptable behaviors and non-acceptable.

For this reason, the proposed Bill once passed into law, could help build stronger relationships between physicians and maternal patients. Emphasize health and safety for healthcare professionals and patients. Postpartum depression is expected to reduce significantly since maternal care and possible treatment outline shall be made available and easily accessible. Conversely, if the Bill fails to pass, maternal issues are anticipated to remain the same and possibly worsen.

Anticipated Legislation Project Cost

Often, proposed legislation, once approved, requires a formal cost estimate except for appropriation bills. Upon the relevant committee’s request, formal cost estimates at other stages are provided. In this case, the proposed maternal care legislation does not have any projected legal cost. According to Langlois et al. (2019), since this proposed legislation is added as a section to an existing statute, the higher cost is covered. More significantly, the legislation acts as a prompt review to strengthen health policy and system analysis for improved health and appropriate case management.

Recommendation to the Governor

Legislative recommendations are crucial to providing more understanding, especially a proposed Bill or proposed legislation added to a section. First, all hospitals should be required to offer substantial maternal care before and after child delivery. Building on Andres et al. (2016), both the mother’s and the child’s health are significant for the husband’s well-being. The uptake of substantial healthcare services can guarantee reduced maternal death. Second, all hospitals and clinical centers offering maternal services should avail the latest information regarding postpartum depression to the mother and her husband. Arguably, most maternal patients, when not appropriately attended to during their discharge, experience moderate to severe postpartum depression. Markedly, this can culminate in devastating effects, even death of both the maternal patient and newborn. The legislative language can be found in section 32.1-134, which elaborate on the significance of upholding competent hospital practice. Third, every healthcare provider attending to a maternal case shall be required to discuss, not only avail, the postpartum depression management information (Vélez et al., 2020). By consulting with the patient alongside the husband, both can be appropriately informed to help each other manage signs and symptoms of postpartum depression.

Similarly, the legislative language, in this case, can be deduced from S. 32.1-134. It emphasizes the role of patient education as an effective treatment plan to achieve recovery. Fourth, hospitals and clinical centers offering maternal services should comply with Medicare and Medicaid payment services for patients without financial ability. Numerous hospitals deny maternal patients discharge and postpartum depression management information due to delayed Medicare and Medicaid payments. Ultimately, this results in poor management of maternal cases, which are a blow to the healthcare sector, societies, and the government. Finally, physician-patient discussion record-keeping is fundamentally significant for future reference and proper diagnosis and treatment. The legislative language places more emphasis on this recommendation as a projection of effective communication.    

Governor’s Support and Statement-Making

Agreeably, there are unnumbered reasons why the Governor should support the Bill and make a statement when passed by the legislature. The new proposed legislation positively impacts the overall hospital practices by integrating competencies for advanced practices. Fundamentally, Molnar et al. (2016) believe that the Bill is a win-win strategy that guarantees beneficial advantages to both the provider and the patient. It is more reason for the Governor to support the Bill. Discharge education on Postpartum Depression is proven to reduce or prevent symptoms associated with PPD.

Furthermore, an integrated study by Curley (2016) indicates that patient education should begin before birth, which significantly minimizes the risks and maximizes its benefits. Educating and supporting women is an indispensable role that should be integrated into nursing care. Accordingly, it helps address treatment options, self-care, and prevention strategies, giving more reasons why the Governor should support the proposed maternal legislation. Supporting this proposed legislation ultimately results in escalated self-efficacy skills necessary for managing low self-esteem and maintaining a social relationship (Curley, 2016). Since there are no pretesting technics to predict postpartum depression after child delivery, educating women and their families before and after birth is undoubtedly essential and beneficial. In most cases, women and families can mistake the postpartum signs and symptoms for other conditions. Eventually, this could culminate in more devastating results.

If the Governor supports the bill while expressing concerns, they should be welcome and analyzed to predict their impact on the proposed legislation. For instance, the Governor could ask how the Bill addresses implementation in remotely located hospitals and clinical centers (Andres et al., 2016). Due to limited health resources, some hospitals can find it challenging to implement some proposed legislation aspects. In the contemporary setting, most medical records are done through advanced technology, which requires electricity. Examples of health information technology include Electronic Health Records, Secure Messaging, and Personal Health records. In such circumstances, the Bill can be amended to require electricity installation and health information systems.

Arguably, there are no substantial reasons for the Governor not to support the proposed Bill once approved by the legislature. Conferring to this discussion’s weight, non-support of the legislation implies wanting conditions anticipated to worsen within the maternal care setting. 

 Conclusion

In conclusion, public health officials and other stakeholders’ involvement in health policy analysis is essential and beneficial to completing proposed health legislation regarding maternity health. The public health policy process creates conditional systems intended to improve health and prevent injury and illness. Undoubtedly, the proposed bill focuses on educating maternal patients and their husbands, alongside keeping the discussion record, introducing a significant element in maternal healthcare. Due to the lack of appropriate policies to address postpartum depression, its prevalence and impact on healthcare have necessitated prompt reviews. Patients, physicians, insurance companies, pharmaceutical firms, and governments are crucial stakeholders with an indispensable role in proposed legislation projects. As with demerits come merits, every proposed Bill has its risks and benefits, which must be examined to detect any potential negatives or positives. Recommendation provisions are crucial for proper bill elaboration and implementation. Indeed, health policy analysis extends beyond the individual’s need to embrace an entire population’s health necessities.

References

Andres, E., Baird, S., Bingenheimer, J. B., & Markus, A. R. (2016). Maternity leave access and health: A systematic narrative review and conceptual framework development. Maternal and Child Health Journal20(6), 1178-1192.

Curley, A. L. (2016). Introduction to population-based nursing. Population-based nursing: Concepts and competencies for advanced practice, 1-22.

Langlois, E. V., Straus, S. E., Antony, J., King, V. J., & Tricco, A. C. (2019). Using rapid reviews to strengthen health policy and systems and progress towards universal health coverage. BMJ global health4(1).

Molnar, A., Renahy, E., O’Campo, P., Muntaner, C., Freiler, A., & Shankardass, K. (2016). Using win-win strategies to implement health in all policies: a cross-case analysis. PloS one11(2), e0147003.

Vélez, M., Wilson, M. G., Abelson, J., Lavis, J. N., & Paraje, G. (2020). Understanding the role of values in health policy decision-making from the perspective of policy-makers and stakeholders: a multiple-case embedded study in Chile and Colombia. International journal of health policy and management9(5), 185.