2 Advocating for Policy Change to Improve Health Outcomes in the Community Advanced Professional Nurse as Advocate Advocacy has been at the forefront of the nursing profession since its inception. The concept of advocacy is taught early and often to student nurses and continues to be promoted in the workplace. How a nurse advocates depends on their unique experiences with patients and caregivers. According to a journal article addressing nurse advocacy as a concept analysis "The concept of patient advocacy is still poorly understood and not clearly conceptualized. Therefore, there is a gap between the ideal of patient advocacy and the reality of practice." (Abassinia et al, 2019). This is an important statement because it reinforces the fact that advocacy can and will look different in each situation as well as within different settings. Nurses advocating for an individual patient within a clinical setting will differ from how a nurse advocates for an at-risk population. A simple example is comparing what exactly the nurse is advocating for. In a clinical setting, advocating for a single patient, the need will be specifically related to that patient, either recognized by the nurse or expressed by the patient. When advocating for an at-risk population the need may not be as obvious. The advanced practice nurse will need to research the at-risk population and determine the shared need of the community as well as health inequities influencing this shared need. An additional difference is: Once the nurse has determined what he or she is advocating for, there is a difference in whom they advocate to. In a clinical setting, the nurse will involve the different providers of the care team, advocate for the patient's needs, and typically carry out tasks to meet those needs. An example is a patient at risk for several comorbidities due to adult obesity. In the clinical setting,
3 the nurse can incorporate different ancillary departments to meet the needs of the patients. This may include setting up classes with the nutritionist or referring the social worker to provide resources for food assistance. When advocating for an at-risk population the advanced practice nurse must first determine what influences or lack of resources are involved in the at-risk population suffering from adult obesity. They must construct a plan that addresses how to decrease the incidence of adult obesity within this at-risk population based on the determined influences or lack of resources. Finally, the advanced practice nurse must gain buy-in from community stakeholders to implement the plan. The process is much more in-depth and requires the know-how to not only conduct the needed research but present it to the right policymakers within the community. According to Maryland and Gonzalez, "Although elected officials frequently are tasked with taking positions on various healthcare proposals, it is nurses who understand healthcare issues and are trusted by patients and the public." (Maryland & Gonzalez, 2012). Interprofessional Collaboration Two evidence-based strategies advanced practice nurses can implement within their advocacy action teams to promote interprofessional collaboration are role clarification and shared decision-making. Understanding each person's role and responsibilities can ensure the team is efficient by reducing role overlap and ensuring assigned tasks are not missed. Shared decision-making is important because it creates an environment of open communication where the team is working together to determine the best solution to the problem. According to a study conducted at Sunnybrook Health Sciences Center in Toronto, Ontario, Shared decision-making, and role clarification are two of the six core competencies for interprofessional collaboration (McLaney et al, 2022). It is especially important for an action advocacy team to have role
4 clarification and shared decision-making due to the diversity of the group. Specifically, when approaching a community health issue, there will be stakeholders that may not have a healthcare background, because of this, role clarification is even more important. In addition, shared decision-making opens lines of communication so all stakeholders are on the same page and can determine a shared purpose and how to achieve it. Data Driven Health Issue According to the website countyhealthrankings.org, the county of San Bernardino in California has a significant adult obesity rate. San Bernardino County has had a larger adult obesity percentage than the state of California since at least 2019. Currently, for 2023 San Bernardino has an adult obesity rate of 39%, whereas California as a state is much lower at 30%. In addition, of the 58 counties in California, San Bernardino is dead last with the highest adult obesity rate in the state for 2023 (County Health Rankings & Roadmaps, 2023). Characteristics of At-Risk Population
Order this paper