Policy, Politics, and Nursing Practice最新文献

Making up over 80% of the global health workforce, nurses are essential for meeting public health goals like Healthy People 2030 and the Sustainable Development Goals. Despite this, nurses remain underrepresented in leadership and policy development. The program was created to equip pre-licensure, master's entry into nursing students with foundational policy skills through a two-semester extracurricular enrichment program. It combines classroom learning with mentored policy projects, offering practical experience on key health policy issues like HIV prevention and end-of-life care. Early student feedback led to program adjustments, emphasizing peer learning. This paper describes the policy mentorship program and corresponding seminar. It provides a detailed description of the program so that other nursing schools can adopt components or design similar programs to help students hone the critical competencies required to navigate the sociopolitical systems that define our healthcare approach and mediate disease and wellness.

The issue of workplace violence (WPV) in health care is a critical concern affecting the safety of health care workers, patient care quality, and organizational sustainability. WPV encompasses various forms of violence, such as verbal abuse, assault, harassment, and intimidation, leading to emotional and physical harm for health care workers. The consequences of WPV extend beyond individual workers to impact patient care, workforce stability, and economic cost for health care organizations. Analysis of policy alternatives considers factors such as cost, quality, access, equity, feasibility, resources required, implementation strategies, and long-term sustainability. The SAVE Act emerges as a comprehensive solution with broad support from key contributors despite challenges related to federal legislative processes and financial commitments. State-specific policies in New Hampshire, Connecticut, and New York offer targeted approaches but may face limitations in scope, funding, and enforcement mechanisms compared to federal guidelines. Addressing WPV in health care requires a multifaceted approach involving legislative actions, organizational initiatives, advocacy group collaborations, and resource allocations. The SAVE Act stands out as a promising solution with the potential to improve workplace safety, protect health care workers' rights and enhance patient care outcomes. However, careful planning, resource management, and ongoing evaluations are necessary to ensure effective implementation and sustain impact in reducing WPV across health care settings.

Florence Nightingale's mid-19^th-century reforms-especially her emphasis on sanitation, holistic patient care, and empirical data-catalyzed the transformation of nursing from an unregulated, low-status occupation into a respected, professional field. American institutions rapidly adopted her model, establishing standardized training programs followed by state licensure. Yet, by framing nursing around traits traditionally coded as feminine (compassion, nurturing, moral duty), these reforms inadvertently excluded men, who had historically provided significant direct patient care in military, psychiatric, and community settings. This article employs a critical gender-theoretical lens-integrating feminist standpoint theory and Foucauldian analyses of power/knowledge-to explore how Nightingale's legacy simultaneously elevated the nursing profession and entrenched enduring gendered hierarchies. The article examines specific policies shaped by Nightingale's model, such as state nurse-registration laws, military nursing corps restrictions, and early American Nurses Association (ANA) bylaws, demonstrating how institutionalized gender norms marginalized male practitioners. It asserts that while Nightingale deserves acclaim for professionalizing nursing, the discipline must also reckon with her legacy's exclusionary effects. Finally, the article proposes concrete strategies to deconstruct persistent gender biases and foster a more inclusive nursing profession.

IntroductionIntermediate care is a healthcare model designed to bridge the gap between hospital care and home, focusing on the efficient treatment and rehabilitation of patients after hospitalization. Its primary goals include facilitating early discharge, promoting patient independence, and preventing hospital readmissions. While previous studies have shown promise regarding the effectiveness of intermediate care, they often report mixed results, underscoring the necessity for further investigation. This review aims to evaluate the efficacy of bed-based intermediate care services in enhancing patient outcomes during the post-hospital discharge process.MethodsA systematic search was conducted across major scientific databases to identify relevant literature. The inclusion criteria focused on primary experimental studies that reported outcomes related to mortality, post-discharge care settings, functional status, length of hospitalization, rates of hospital readmission, and both physical and psychological well-being, as well as cost-effectiveness.ResultsA total of six articles met the inclusion criteria. The findings generally suggest a favorable impact of intermediate care facilities on patient outcomes. However, it is important to note that the data exhibited low statistical significance. The evidence indicates that intermediate care facilities are at least as effective as traditional hospital care, which carries a significantly higher financial burden.ConclusionsAlthough the statistical significance of the results is limited, the trends indicate that intermediate care facilities may serve as suitable and economically viable alternatives for post-hospital care. Further research with larger sample sizes and more robust methodologies is necessary to confirm these findings and fully understand the role of intermediate care in enhancing patient outcomes.

This article presents a comprehensive stakeholder analysis within the context of opioid overdose prevention in Boston, showcasing the development and application of an integrated framework designed to address the complex dynamics of the opioid crisis. Utilizing a modified Agency for Healthcare Research and Quality stakeholder analysis tool, this study categorized key stakeholders into four main groups: healthcare providers, law enforcement officers, health policy officials, and community leaders. Through in-depth, semistructured interviews with 15 stakeholders recruited from Boston's Mayor's Task Force for Opioid Remediation, we synthesized insights to map out strategic intelligence essential for policy formulation and enhanced stakeholder engagement. The analysis highlighted the necessity of multisector collaboration and identified critical leverage points that could influence future interventions. The findings underscored the potential of tailored interventions that consider the unique needs and contributions of different stakeholder groups, advocating for policy reforms that support comprehensive public health strategies. The integrated framework represents a proposed implementation model for Boston, demonstrating adaptability for other urban settings. The framework introduces innovative strategies for continuous improvement and adaptation, informed by stakeholder feedback. This research contributes to the field by demonstrating the effectiveness of stakeholder analysis in developing actionable and sustainable public health policies, providing a replicable model for other urban settings facing similar public health challenges.

The human papillomavirus (HPV) vaccine is a critical tool in cervical cancer prevention, yet uptake remains suboptimal in the United States. This scoping review examines the multilevel determinants influencing HPV vaccine uptake among women, identifying key barriers and facilitators to vaccination. Using the socioecological model (SEM), this review categorizes factors affecting vaccine uptake across individual, interpersonal, community, and societal levels, providing a structured framework for analyzing multilevel influences. Studies published in English between 2009 and 2023 were systematically reviewed, focusing on HPV vaccine uptake determinants among U.S. females aged 9 to 45, aligning with vaccination guidelines. Fifteen studies were included in the final analysis. However, studies including older adults (up to 80 years) were analyzed to explore vaccine awareness trends and decision-making beyond the routinely recommended age groups. Excluded were studies focusing solely on healthcare providers' perspectives, those conducted outside the United States, and non-English language publications. A comprehensive search of PsycINFO, CINAHL, and PubMed was conducted using relevant keywords to ensure a thorough literature review. Findings indicate that multiple interrelated factors, including misinformation, healthcare provider recommendations, socioeconomic status, insurance coverage, cultural beliefs, and geographic disparities, shape vaccine hesitancy. Key barriers include a lack of provider recommendations, financial constraints, and concerns about vaccine safety, while facilitators include strong provider communication and targeted educational interventions. Addressing these barriers through multilevel interventions such as provider training, policy reforms, and community-driven outreach will be essential for increasing HPV vaccine uptake and reducing cervical cancer disparities among underserved populations.

This article discusses the development of professional advocacy in the U.K. nursing and midwifery professions. Initially established in midwifery, the discourse of professional advocacy has gradually shifted from a patient focus to advocating for the professionals in their professional roles. This move is driven by the need to influence the health, well-being, and efficacy of the health professions, thereby positively impacting patient care. The concept of advocacy is thus expanding from advocacy focussing on patients/social groups, to incorporating advocating for health professionals by health professionals. However, it is unclear if literature and evidence is keeping pace with this potential conceptual shift taking place in the practice setting, and it is unclear if past patient-centered conceptualizations of advocacy are relevant to the context of professional-oriented advocacy. This article aims to initiate this discussion specific to the nursing profession.