This document summarizes key points from Chapter 3 of a nursing course on health policy, politics, and reform. It discusses several topics related to healthcare policy including the political process, healthcare finance, access to care, nursing's role in policy, quality of care, and the Affordable Care Act. It also provides sample questions and answers about these topics.

1. NUR 4636 Nursing Course Reflection Paper 2
NUR 4636 Nursing Course Reflection Paper 2NUR 4636 Nursing Course Reflection Paper
2Chapter 3: Health Policy, Politics, and Reform Chapter Highlights #1 ❖Healthcare policy
and the political process ❖Healthcare finance and cost–benefit in relation to health policy ❖
Access to healthcare and insurance facts in the United States ❖Healthcare workforce
diversity and its effects on the quality of healthcare ❖Nursing’s role in shaping healthcare
policy Copyright © 2020 Wolters Kluwer · All Rights Reserved Chapter Highlights #2 ❖
Quality of care and evaluation ❖Information management facts ❖Equity in healthcare
access ❖Ethical consideration in health policy ❖Political advocacy, how to be politically
active and advocate Copyright © 2020 Wolters Kluwer · All Rights Reserved Chapter
Highlights #3 ❖Health advocacy and healthcare reform ❖Affordable Care Act (ACA)
overview and updates ❖Community-based services and healthcare reform ❖Health
services research application to healthcare policy Copyright © 2020 Wolters Kluwer · All
Rights Reserved Healthcare Policy and Political Process ❖Policies: set of principles that
govern an action to achieve a given outcome, or guidelines that direct individuals’ behavior
toward a specific goal ❖Public health policy: decisions made in regard to the health of the
individual and the community ❖Health policies: impact on the health of an individual, a
family, and a population or community Copyright © 2020 Wolters Kluwer · All Rights
Reserved Question #1 Is the following statement true or false? Health policies impact on the
health of an individual, a family, and a population or community. Copyright © 2020 Wolters
Kluwer · All Rights Reserved Answer to Question #1 True Rationale: Health policies impact
on the health of an individual, a family, and a population or community. Copyright © 2020
Wolters Kluwer · All Rights Reserved Involving Politics ❖Process of influencing the
allocation of resources needed to enable policy and involves the strategies needed to
achieve the desired goals. ❖NUR 4636 Nursing Course Reflection Paper 2ORDER NOW FOR
CUSTOMIZED, PLAGIARISM-FREE PAPERSPolicy-making takes a great deal of effort, time,
and commitment. o Setting an agenda o Policy formulation o Policy adoption o Policy
implementation o Policy assessment o Policy modification Copyright © 2020 Wolters
Kluwer · All Rights Reserved Healthcare Finances and Cost-Benefit ❖Economics is the study
of how individuals, groups, organizations, and society allocate and utilize resources. ❖When
a policy is evaluated for its effectiveness, there is an interest in keeping the cost of a specific
health program within reason, and it is critical to consider the overall costs and benefits of
an existing program when a more efficient and effective service is identified and adopted.
Copyright © 2020 Wolters Kluwer · All Rights Reserved Access to Care and Health

2. Insurance ❖The U.S. healthcare system is a unique system of both independent and
collaborative power and action by both federal and state governments. Copyright © 2020
Wolters Kluwer · All Rights Reserved Question #2 Is the following statement true or false?
The U.S. healthcare system is a unique system of both independent power and action by the
federal government. Copyright © 2020 Wolters Kluwer · All Rights Reserved Answer to
Question #2 False Rationale: The U.S. healthcare system is a unique system of both
independent and collaborative power and action by both federal and state governments.
Copyright © 2020 Wolters Kluwer · All Rights Reserved Nursing’s Role in Shaping
Healthcare Policy ❖Nursing has a rich history as a unique profession, with its own values,
ethics, respect, integrity, and responsibility. Nurses’ contributions to the policies are
unlimited; there is a need for greater coordination of action to ensure that nursing is
actively supported and involved in influencing and shaping health and healthcare policies.
Copyright © 2020 Wolters Kluwer · All Rights Reserved Historical Highlights on Nursing
Political Involvement ❖Mid-‘70s and early ‘80s: Political involvement of nurses ❖1976:
Important year of advocacy ❖1990s: Nurses included in healthcare policy formation
Copyright © 2020 Wolters Kluwer · All Rights Reserved What Does It Mean to Be Politically
Active? ❖Personal and professional political involvement of nurses ❖Nurses must be
knowledgeable about issues, laws, and policy ❖Why is nurse-informed political
involvement? o Direct caregivers o Awareness of patient safety and satisfaction, access to
services, clinical outcomes, and health disparities o Positioned to see impact of policy on
individuals Copyright © 2020 Wolters Kluwer · All Rights Reserved Nursing Advocacy and
Policy Participation ❖Patient advocacy ❖Political advocacy Copyright © 2020 Wolters
Kluwer · All Rights Reserved How to Be Politically Involved? ❖Evidence-based practice
examples ❖Nurses’ milestones in policy development have contributed to: o Quality
outcomes o Decreases in cost o Expanded access o Major differences to the health of the
nation Copyright © 2020 Wolters Kluwer · All Rights Reserved Advocacy Activities of
Professional Nursing Organizations ❖Role of professional nursing organizations o ANA o
NLN o ICN Copyright © 2020 Wolters Kluwer · All Rights Reserved Current Situation of
Nursing Involvement: Challenges and Barriers ❖Not enough time to get involved ❖Heavy
workloads with understaffing ❖Perception of powerlessness ❖Gender issues ❖Political
action breaching family time ❖Anxiety with public speaking ❖Lack of knowledge in
legislative process ❖Fear of retaliation Copyright © 2020 Wolters Kluwer · All Rights
Reserved Quality of Care ❖Safety ❖Effectiveness ❖Patient centeredness ❖Timeliness ❖
Equality ❖Quality of care is defined by the Institute of Medicine (2001) as the degree to
which health services for individuals and populations increase the likelihood of desired
outcomes, and are consistent with current knowledge. ❖It is extremely difficult to evaluate
the complexities of the quality of care for the U.S. population. Copyright © 2020 Wolters
Kluwer · All Rights Reserved Information Management ❖U.S. policy-makers have made the
adoption of health information technology a priority so that health records can be kept
electronically, assisting patients, providers, and insurers. Copyright © 2020 Wolters Kluwer
· All Rights Reserved Equity and Equality in Healthcare Access and Quality ❖Because of the
vast disparities in healthcare access and quality, President Obama has made healthcare his
top priority, promising affordable and adequate healthcare insurance for all Americans.

3. Copyright © 2020 Wolters Kluwer · All Rights Reserved Question #3 Is the following
statement true or false? Equality is healthcare that does not vary in quality because of
gender, race, ethnicity, geographic location, or socioeconomic status. Copyright © 2020
Wolters Kluwer · All Rights Reserved Answer to Question #3 True Rationale: Equality is
healthcare that does not vary in quality because of gender, race, ethnicity, geographic
location, or socioeconomic status. Copyright © 2020 Wolters Kluwer · All Rights Reserved
Community-Based Services Association with Healthcare Reform ❖Federally qualified health
centers ❖Patient-centered medical home ❖Accountable care organizations ❖Meaningful
use Copyright © 2020 Wolters Kluwer · All Rights Reserved Ethical Considerations ❖ANA
Code of Ethics with Interpretive Statements ❖NUR 4636 Nursing Course Reflection Paper
2Code of Ethics for Nurses ❖Social Policy Statement ❖Scope and Standards of Practice in
Nursing Copyright © 2020 Wolters Kluwer · All Rights Reserved Health Advocacy and
Healthcare Reform ❖Advocacy is collaborating with colleagues and engaging in
conversations with decision-makers ❖Healthcare systems are dynamic Copyright © 2020
Wolters Kluwer · All Rights Reserved Overview of the ACA Prior to the End of Obama
Presidency ❖Patient Protection and Affordable Care Act ❖Health Care and Education
Reconciliation Act Copyright © 2020 Wolters Kluwer · All Rights Reserved Health Services
Research ❖Research continues to be an influencing power by documenting the need for
accelerated reform in order to achieve quality care, proper information management,
insurance for all, and equity of access. Copyright © 2020 Wolters Kluwer · All Rights
Reserved Chapter 15: Emerging Infectious Diseases Chapter Highlights ❖Emerging versus
reemerging infectious diseases ❖Factors that influence the emergence/reemergence of
infectious diseases ❖Recent emerging/reemerging infectious diseases ❖Prevention and
control of emerging and reemerging infectious diseases ❖Reemergence of vaccine‐
preventable diseases Copyright © 2020 Wolters Kluwer · All Rights Reserved Question #1
Is the following statement true or false? Factors that influence the emergence or
reemergence of infectious diseases are multiple, complex, and interrelated. Copyright ©
2020 Wolters Kluwer · All Rights Reserved Answer to Question #1 True Rationale: Factors
that influence the emergence or reemergence of infectious diseases are multiple, complex,
and interrelated. Copyright © 2020 Wolters Kluwer · All Rights Reserved Emerging
Infectious Disease ❖A newly identified clinically distinct infectious disease or the
reappearance (or reemergence) of a known infectious disease after its decline with an
incidence that is increasing in a certain geographic area or in a specific population
Copyright © 2020 Wolters Kluwer · All Rights Reserved Factors That Influence Emerging
Infectious Diseases ❖Microbial adaptation and change ❖Human susceptibility to infection
❖Climate, changing ecosystems, and human behavior ❖Travel, technology, and industry ❖
Lack of political will and breakdown of public health infrastructure Copyright © 2020
Wolters Kluwer · All Rights Reserved Question #2 Is the following statement true or false?
Epidemics and pandemics can place long‐term demands on healthcare systems. Copyright
© 2020 Wolters Kluwer · All Rights Reserved Answer to Question #2 False Rationale:
Epidemics and pandemics can place sudden and intense demands on healthcare systems.
Copyright © 2020 Wolters Kluwer · All Rights Reserved Recent Emerging and Reemerging
Infectious Diseases #1 ❖Severe acute respiratory syndrome ❖MERS‐CoV ❖Avian influenza

4. ❖H1N1 Influenza ❖Novel Avian influenza A ❖West Nile virus Copyright © 2020 Wolters
Kluwer · All Rights Reserved Recent Emerging and Reemerging Infectious Diseases #2 ❖
Lyme disease ❖E. Coli 0157:H7 ❖Tuberculosis ❖Ebola virus disease ❖Zika virus disease
Copyright © 2020 Wolters Kluwer · All Rights Reserved Question #3 Is the following
statement true or false? Certain zoonotic diseases can be transmitted to humans through
contact with zoo animals. Copyright © 2020 Wolters Kluwer · All Rights Reserved Answer
to Question #3 False Rationale: Certain zoonotic diseases can be transmitted to humans
through contact with animals and birds. Copyright © 2020 Wolters Kluwer · All Rights
Reserved Reemerging Vaccine‐Preventable Diseases ❖
NUR 4636 Nursing Course Reflection
Paper 2Measles ❖Mumps ❖Rubella ❖Pertussis Copyright © 2020 Wolters Kluwer · All
Rights Reserved Antibiotic‐Resistant Microorganisms #1 ❖Urgent threats o Clostridium
difficile o Carbapenem‐resistant Enterobacteriaceae o Neisseria gonorrhoeae ❖Serious
threats ❖Concerning threats Copyright © 2020 Wolters Kluwer · All Rights Reserved
Antibiotic‐Resistant Microorganisms #2 ❖Urgent threats ❖Serious threats ❖Concerning
threats Copyright © 2020 Wolters Kluwer · All Rights Reserved Question #4 Is the following
statement true or false? Outbreaks of emerging and reemerging infections can disrupt
economic activity and development. Copyright © 2020 Wolters Kluwer · All Rights
Reserved Answer to Question #4 True In addition to morbidity and mortality, outbreaks of
emerging and reemerging infections can disrupt economic activity and development.
Copyright © 2020 Wolters Kluwer · All Rights Reserved Chapter 1: Public Health Nursing:
Present, Past, and Future Chapter Highlights ❖Healthcare changes in the 21st century ❖
Characteristics of public health nursing ❖Public health nursing roots ❖Challenges for
practice in the 21st century Copyright © 2020 Wolters Kluwer · All Rights Reserved
Question #1 Is the following statement true or false? Healthcare disparities are social
conditions in which people live and work. Copyright © 2020 Wolters Kluwer · All Rights
Reserved Answer to Question #1 False Rationale: Social determinants of health are social
conditions in which people live and work. Healthcare disparities are gaps in healthcare
experienced by one population compared with another. Copyright © 2020 Wolters Kluwer ·
All Rights Reserved Major Changes in Healthcare in the 21st Century ❖Development of
patient/client-centered care ❖Increased use of technology ❖Increased personal
responsibility Copyright © 2020 Wolters Kluwer · All Rights Reserved Healthcare Changes
in the 21st Century #1 ❖Social determinants of health are social conditions in which people
live, their income, their social status, their education, their literacy level, their home and
work environment, their support networks, their gender, their culture, and the availability
of health services Copyright © 2020 Wolters Kluwer · All Rights Reserved Healthcare
Changes in the 21st Century #2 ❖Healthcare disparities—differences in healthcare and
health outcomes experienced by one population compared with another Copyright © 2020
Wolters Kluwer · All Rights Reserved Role of Government in Healthcare ❖Three core
functions are as follows: o Assesses healthcare problems o Intervenes by developing
relevant healthcare policy that provides access to services o Ensures that services are
delivered and outcomes are achieved Copyright © 2020 Wolters Kluwer · All Rights
Reserved Patient Protection and Affordable Care Act (PPACA) ❖Provide affordable health
insurance coverage to most Americans ❖Lower costs ❖Improve access to primary care ❖

5. Preventive care and prescription benefits ❖Cover pre-existing conditions ❖Extend young
adults’ coverage Copyright © 2020 Wolters Kluwer · All Rights Reserved Question #2 ❖
What is one of the core functions of the role of government in healthcare? A. Provide
affordable health insurance coverage B. Improve access to primary care C. Lower costs D.
Assess healthcare problems Copyright © 2020 Wolters Kluwer · All Rights Reserved
Answer to Question #2 D. Assess healthcare problems Rationale: Three core functions are
to assess healthcare problems, intervene by developing relevant healthcare policy that
provides access to services, and ensure that services are delivered and outcomes are
achieved. One of the goals of the Patient Protection and Affordable Care Act (PPACA) is to
provide affordable health insurance coverage. Copyright © 2020 Wolters Kluwer ·NUR
4636 Nursing Course Reflection Paper 2All Rights Reserved Patient/Client-Centered Care ❖
Cultural traditions ❖Personal preferences ❖Values ❖Families ❖Lifestyles Copyright ©
2020 Wolters Kluwer · All Rights Reserved Technology ❖Rapidly advancing forms of
technology are dramatically improving lives. Copyright © 2020 Wolters Kluwer · All Rights
Reserved Health Information Technology ❖Health information technology (HIT)—
comprehensive management of health information and its exchange between consumers,
providers, government, and insurers in a secure manner ❖Electronic health records
Copyright © 2020 Wolters Kluwer · All Rights Reserved Telehealth ❖Use of electronic
information and telecommunications technologies to support long-distance clinical
healthcare, patient and professional health-related education, public health, and health
administration Copyright © 2020 Wolters Kluwer · All Rights Reserved Personal
Responsibility for Health ❖Active participation in one’s own health through education and
lifestyle changes Copyright © 2020 Wolters Kluwer · All Rights Reserved Public Health
Nursing ❖Public health nursing—population-based practice, defined as a synthesis of
nursing and public health within the context of preventing disease and disability and
promoting and protecting the health of the entire community Copyright © 2020 Wolters
Kluwer · All Rights Reserved Principles of Public Health Nursing #1 ❖Client or unit of care
is the population. ❖Primary obligation is to achieve the greatest good for the greatest
number of people or people as a whole. ❖Public health nurses collaborate with the client as
an equal partner. Copyright © 2020 Wolters Kluwer · All Rights Reserved Principles of
Public Health Nursing #2 ❖Primary prevention is the priority in selecting appropriate
activities. ❖Public health nursing focuses on strategies that create healthy environmental,
social, and economic conditions in which populations may thrive. Copyright © 2020
Wolters Kluwer · All Rights Reserved Principles of Public Health Nursing #3 ❖A public
health nurse is obligated to actively identify and reach out to all who might benefit from a
specific activity or service. ❖Optimal use of available resources and creation of new
evidence-based strategies is necessary to assure the best overall improvement in the health
of populations. Copyright © 2020 Wolters Kluwer · All Rights Reserved Principles of Public
Health Nursing #4 ❖Collaboration with other professions, populations, organizations, and
stakeholder groups is the most effective way to promote and protect the health of people.
Copyright © 2020 Wolters Kluwer · All Rights Reserved Scope and Standards of Practice ❖
The American Nurses Association sets the scope and standards for all professional nursing
practice. ❖The publication Public Health Nursing: Scope and Standards of Practice

6. establishes the characteristics of competent public health nursing practice and is the legal
standard of practice. Copyright © 2020 Wolters Kluwer · All Rights Reserved Competencies
for Public Health Nursing Practice ❖Three tiers of practice ❖Competencies associated with
that level of practice Copyright © NUR 4636 Nursing Course Reflection Paper 2