Discussion: Policy Brief NURS 8100 Discussion: Policy Brief

Discussion: Policy Brief NURS 8100 Discussion: Policy Brief

This is a call for nurses to lead at every level to have a seat at the table when critical decisions are being made. Those decisions extend from clinical care to national policy, and all require the voice of nurses (Institute of Medicine, 2010). Based on my analysis of the policy proposal, the Institute of Medicine get it right. A perfect example of how this works can be seen when the nursing staff members of the Veterans Health Administration (VHA) healthcare team voiced confidence and interest in assisting patients to achieve blood glucose level goals. They heard patients’ voices of frustration in their inability to attain more frequent access to the clinic provider above the usual three-month follow-up visits. This resulted in management inertia about insulin dosage adjustments based on their home and laboratory glucose values. Patients knew that they needed to change their medications but had no power to do so. The Veterans Health Administration (VHA) metabolic and diabetes nursing field advisory committee created a vision, recognizing that together with Veteran stakeholder input and partners in nutrition, behavioral health, pharmacy, and medicine. They created a diabetes program to provide state-of-the-art evidence-based interventions that are timely and Veteran-centric (U.S. Department of Veterans Affairs, 2015).

This article reviews patients’ actions reflected by carrying out medication lists to diminish information loss from health care settings and identifying support for patient safety. The study reveals priorities for improving medication safety in primary care by addressing incomplete medication reconciliation. The strength of the study is reflected by the empowerment and confidentiality inspired to patients by involvement in medication management, increasing their dignity and self-esteem level, evidencing a form of resilience in nursing practice. Patient-held medication lists may be helpful for information transfer in emergency situations when communication is altered. Patient-held medication lists assist with taking medications, reordering, monitoring health care conditions, or tracking the efficiency of medications. The weakness of the study is reflected by possible disconnections between the information needs by health care professionals and the information being kept by patients who carried medication lists. Another limitation of the study is interviewing more females than males who carried a medication list, and the procedure suggests that more females carry a medication list than males and may reflect an inaccurate practice (Garfield et al., 2020).

The Office of Nursing Service (ONS) diabetes experts collaborated with the VA national home telehealth department and nutrition field advisors to compile daily prompts, knowledge, and affirmations on diabetes safety and self-care. The program was field-tested with patients and continues to teach diabetes self-management skills on a daily basis through short mobile telephone messages that meet the patient’s learning needs in short bursts of learning. Members of the medical and nursing field advisory committees worked together to create an insulin titration protocol to be piloted at five VHA facilities. They brought together an interprofessional team of field-based diabetes experts including physicians, clinical psychologists, pharmacists, and nurses, and created a training program based upon the Project ECHO model from New Mexico. Project ECHO (Extension for Community Health Outcomes) is a telehealth program started in 2009 (Brown et al., 2016). Weekly videoconferences were held by specialists for rural clinicians. Theoretical didactic content was presented by a panel of experts who then mentored the learners in utilizing theory by talking them through actual patient case presentations. Best practices were taught by theory and then integrated into practice (U.S. Department of Veterans Affairs, 2015).