Running head: HEALTH CARE POLICY DEVELOPMENT

Health Care Policy Development

Jessica Organt
Bon Secours Memorial College of Nursing
Business of Health Care in Complex Systems
Nur 4240
Catherine Mikelaites
July 25, 2015

I pledge

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Health Care Policy Development

Health care policies impact all aspects of healthcare; not only in nursing. Healthcare laws
get passed every year at the federal, state and local level that determine standards of practice in
healthcare. These laws determine policies and procedures that are put in place to maintain safe,
quality, and effective patient care for all patients, as well as maintaining safety for the healthcare
workers themselves.
Policy Development
Anyone can bring forth an idea into legislation. When a bill first gets introduced into
legislation, it is given a number specific to that bill. H.R. before a bill signifies a House bill,
where S. refers to a Senate bill. The bill is then referred to multiple committees with jurisdiction
over the primary issue of the legislation who then write a report of the bill, describing the
purpose of the bill and impact the bill may have on existing laws in place. It is then decided by
the Speaker of the House whether or not the bill will go before the full body for debate, final
amendment and passage, and requires a majority vote rule. Once the House or Senate passes a
bill, it is then brought to the other chamber where the same process is followed.
The conference meets to make any changes to the bills and may be sent back to the
originating chamber to vote on any changes made. If larger more significant changes are made to
the bill, the conference committee may join to put together one bill from the changes that have
been requested from both chambers. Once a conference is held on each bill and a final draft is
accepted, it is then passed on to the President. If the President approves the law and signs off on
it, or if the President does not take action in ten days while Congress is in session, the bill then
becomes a law. If the President does not sign the bill, he can veto the bill, and an override will be
needed by Congress with a two-thirds vote to pass the bill to a law (Naeyc, n.d.).

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Advocacy Groups
Centers for Disease Control and Prevention. The Centers for Disease Control and
Prevention, or CDC, works to protect America from health, safety, and security threats both from
in the U.S. and from foreign nations. The CDC conducts scientific trials to get critical results to
keep America safe and educated. The CDC also works against any new health threats that may
arise, and work to educate healthcare workers and keep the public well informed. The CDC
began an initiative called the Public Health Emergency Law Program where they work to
increase the competencies of practitioners to use law and strengthen the legal preparedness of all
public health systems. The CDC also works to disperse critical information obtained through
their studies to influence lawmakers and Congress (CDC, 2006).
American Nurses Association. The American Nurses Association, or ANA, is an
organization that represents the nations registered nurses and works to advance the nursing
profession by setting standards of nursing practice, promoting safety in the work environment,
promoting the rights of the nurses in the workplace, and giving a realistic view of nursing (ANA,
2015). The ANAs Federal Government Affairs program works on behalf on nurses to bring
forth safety issues, general practice concerns, and changes to legislation to better the nursing
profession (ANA, 2015). The ANA encourages its nurses to share their voice and concerns to
bring about change in nursing.
The Joint Commission. The Joint Commission is a not-for-profit organization that is
responsible for accrediting over 20,500 hospitals nation-wide. The Joint Commission
accreditation has become known as a symbol of quality and the standard for health care (The
Joint Commission, 2015). One of the drives of the Joint Commission is to set up standards for
the healthcare industry to maintain the highest level of care in all healthcare industries, using a

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survey that they have set up. All hospitals accredited by the Joint Commission or TJC, follow the
survey to maintain the standard of care in their facility. One way that TJC advocates for nursing
and law, is they have set up standards that determine the safe nurse to patient ratios. This does
not only protect the patient from having a nurse on an understaffed unit, but protects the nurse as
well. Although the Joint Commission does not write the laws, many of the standards of care and
practice are based on their survey points, and helps to find holes in the healthcare system and to
define areas that need more attention or work.
American Heart Association. The American Heart Association, or AHA, is an
organization that works to educate the general public on the importance of cardiovascular health.
The AHA spreads awareness on the effects of hypertension, smoking, hypercholesterolemia, and
living an inactive lifestyle on overall cardiovascular health. Although the AHA does not write
laws themselves, they too advocate on behalf of the publics health at federal and state levels, to
push for healthier lives of all Americans (American Heart Association, 2015).
Federal Health Care Law
Bill H.R. 1602 Nurse Staffing Standards for Patient Safety and Quality Care Act focuses
on standards for patient to nurse ratios. The law is currently under review. This law could
potentially effect nursing as a profession greatly. For one, it would set standard that must be
maintained setting appropriate nurse to patient ratios. Currently, many facilities have set
standards, but often have to exceed the ratio when there are call outs, nurse shortage, or high
patient acuity. The standards that have been set in the bill state that the ratio for one nurse should
be: one patient to one nurse in trauma emergency rooms and operating rooms, and two patients
to one nurse in critical care settings, labor and delivery, and burn units. Three patients to one
nurse is recommended in telemetry step-downs and antepartum units. Four patients to one nurse

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ratio is what is recommended for medical-surgical floors and acute care psychiatric floors, while
the only suggested floors for five to one ratios are in rehab and skilled nursing units (Congress.
Gov., 2015). Per the bill, numerous studies have shown that patient outcomes are directly related
to registered nurse staffing ratios. A 2002 Joint Commission report showed that the lack of direct
care registered nurses directly contributed to almost a quarter of the unanticipated events that
eventually led to serious injury and even patient death (Congress. Gov., 2015). If this bill is
passed, patient safety and satisfaction would increase because of the increased amount of time
the nurse could spend with each patient. The nurse could complete more frequent rounding when
necessary, ensuring the patients safety and satisfaction in doing so. This law would also help to
protect the nurses as well, as it would help maintain a safe ratio for nurses, ensuring that they do
not exceed a safe limit. It is believed that nurse retention would also increase, as it has been
stated for many nurses their reason for leaving a facility was too high of a patient ratio.
Because nurse retention would increase, the facility would ultimately save money, not
having to train nurses and put them through orientation for weeks, only to have them leave a
short time later. It would, however, require that more nurses be hired to fill the roles where many
facilities are short. Ultimately, with patient safety and satisfaction, as well as nurse satisfaction
and retention increasing, the cost of hiring more nurses would still be less than what is gained in
the long run.
There are a lot of moving pieces that help to set standards for nursing practice. Laws are
passed at the federal, state and local level, and it is encouraged by many organizations and
programs for nurses of every specialty to get involved in the process to improve nursing overall.
Many organizations work to educate not only the healthcare team members, but also the general
public, to help improve the overall health of the nation and patient outcomes.

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References:
American Heart Association. (2015). Advocate. Retrieved from: http://www.heart.org
/HEARTORG/Advocate/Advocate_UCM_001133_SubHomePage.jsp
CDC. (2006). Law and public health at cdc. Retrieved from: http://www.cdc.gov/
mmwr/preview/mmwrhtml/ su5502a11.htm
Congress.Gov. 2015. H.R. 1602: Nurse Staffing Standards for Patient Safety and Quality
Care Act of 2015. Retrieved from: https://www.congress.gov/bill/114th-congress/housebill/1602/text?q=%7B%22search%22%3A%5B%22nurse%2C+healthcare%22%5D%7D
Naeyc. (n.d.). Steps in making a bill a law: The federal legislative process. Retrieved
from: https://www.naeyc.org/policy/federal/bill_law
The Joint Commission. 2015. The joint commission website: Hospital 2015 national
patient safety goals. Retrieved from: http://www.jointcommission.org/standards_information
/npsgs.aspx