health care policy

Improving the quality of healthcare in the United States requires ongoing and evidence-based policy assessment, analysis, and redesign. In “Role of the Registered Nurse in Primary Health Care,” authors Smolowitz, Speakman, Wojnar, et al. (2015) conducted in-depth interviews with registered nurses in a variety of practice fields to determine the actual and projected roles of nurses in direct care and health leadership. As the role of the nurse becomes more central to the delivery of quality care, it becomes critical to codify nursing roles into public health policy. The goal of this research is to provide qualitative evidence that can be used to bolster healthcare policy in the future. Registered nurses are not just at the front lines of healthcare delivery but are uniquely attuned to the diverse needs of stakeholders, from the patient and family to system concerns related to administration and healthcare budgeting. Moreover, team-based healthcare has become increasingly the norm, raising questions about how policy can or should be changed to reflect future realities. The researchers also found that registered nurses perform their roles within three primary contexts, including preventative care, chronic disease management, and immediate practice operations.
The functions of registered nurses also vary considerably depending on the scope of practice. The researchers found that the most prevalent functions registered nurses perform include triage, which is frequently done remotely or over the phone, documentation of health history and status, case management, especially in chronic care cases, hospital management, delegation of care for episodic illnesses, wellness and lifestyle coaching, medication reconciliation and error prevention, staff management, leadership, education, and mentoring, and also advocacy and quality assurance. The authors conclude by discussing the financial implications of policy change designed to reflect the trends in healthcare leadership and management, showing how nurses are instrumental in driving cost-effective care.
References
Smolowitz, J., Speakman, E., Wojnar, D., et al. (2015). Role of the registered nurse in primary health care. Nursing Outlook 63(2): 130-136.