Policy, Briefing Papers, & Testimony
Health Care Reform
The American Academy of Nursing strongly supported efforts to reform health care, recognizing the potential to expand access to cost-effective, high-quality care and to help shift the U.S. health system toward a greater emphasis on primary and preventive care. Saluting the Congress in their passage of comprehensive health reform legislation, the Academy noted the hard work of actually bringing the reform's benefits to consumers. Health care innovation designed and implemented by nurses should be integral to that effort.
The passage of the Patient Protection and Affordable Care Act provided a crucial opportunity to bring reform to health care in this country. The Academy prepared the document "Implementing Health Care Reform: Issues for Nursing" to offer recommendations that can help to improve access to affordable, quality, safe, equitable care that promotes the health of individuals, families, and communities. The recommendations include those that address: Advancing Access to Care Through Full Utilization of APRNs; Nursing and Health Care Workforce; Developing and Implementing Innovative Models of Care; Quality of Care Initiatives; Expanding Nurse Managed Health Clinics and FQHCs; Improving Non-Hospital Care for Seniors; and, New Federal Commission and Advisory Bodies.
The Academy embraced the Robert Wood Johnson landmark report, The Future of Nursing: Leading Change, Advancing Health. The action-oriented blueprint for improving health care calls for the remodeling of a health care system to ensure high-quality, patient-centered care though the leadership of nurses. The report acknowledges that to achieve significant improvements to local, state and national health policy, the largest segment of the health care workforce -- nurses -- need to be fully engaged with other health professions. As a professional partner, providing valuable insights and experiences, the Academy applauds the IOM's focus on evidence-based research and collaboration.
Advance Care Planning
For many Americans, advance care planning is not a conversation that one brings up until they are faced with advanced illness. The importance of family involvement and the solutions to achieving meaningful, informed provider/family conversation was discussed at the American Academy of Nursing's Raise the Voice Critical Conversation "Best Practices in Advanced Care Planning and Decision Making: Models that Work." The catalyst for the Critical Conversation was a policy brief developed by an Academy Task Force in 2012 entitled "Advance Care Planning as an Urgent Public Health Concern" identifying four policy recommendations for ensuring that conversations about informed preferences are on going and the norm.
Care Coordination
In 2012, the Academy’s Care Coordination Task Force led by Pamela Cipriano, PhD, RN, FAAN, developed a policy brief that has been shared with leadership of the Centers for Medicare and Medicaid Services (CMS).
Breastfeeding
The Academy Breastfeed Expert Panel has actively pursued opportunities to support the recent Surgeon General's Call to Action, which outlines the health benefits of breastfeeding for infants and mothers.
Children and Families
The Academy issued a statement in 2008 strongly supporting the State Children's Health Insurance Program (SCHIP) recognizing the reduction of the number of uninsured children by a third since its creation, and the provision of health coverage to approximately six million children.
Emerging and Infectious Diseases
In 2011, the Academy applauded the U.S. Centers for Disease Control and Prevention (CDC) on their new national public education campaign "Testing Makes Us Stronger" that promotes the benefits and importance of HIV testing. The Academy on behalf of the Emerging and Infectious Diseases Expert Panel called for the adoption of the 2006 Centers for Disease Control and Prevention (CDC) recommendation supporting routine HIV testing in all health care settings and streamlining the administrative operations of widespread testing.
GLBT Health
In July 2011 the Academy Board approved the initiation of the Gay, Lesbian, Bisexual, Transgender (GLBT) Health Expert Panel to provide input on issues affecting the health care of individuals within the GLBT community, promoting nursing participation in research on GLBT health, and developing policy recommendations to reduce health inequities based on sexual orientation or gender identity. The panel reinforces the Academy's commitment to diversity and inclusion and aligns the Academy with the Institute of Medicine in recognizing the importance of research efforts on GLBT health, as identified in the April 2011 IOM report: The Health of Lesbian, Gay, Bisexual, and Transgender (LGBT) People: Building a Foundation for Better Understanding.
Genetics
An Academy white paper entitled Nurses Transforming Health Care Using Genetics and Genomicswas developed in 2009 highlighting the unique perspective nurses bring to the delivery of health care in the areas of genetics/genomics.
Global Nursing and Health Care
The Academy in August 2011 on behalf of the Global Nursing and Health Care Expert Panel co-chaired by Marsha Fowler and Lynda Wilson, wrote to Director-General of the WHO Margaret Chan expressing strong concern that there has not been an individual named to fill the position of Chief Nurse Scientist at the WHO Headquarters.
Health Behavior
The Academy launched an Expert Panel on Health Behavior in 2011 to address the health needs of populations, providing a forum for nurse leaders to advance evidence-based innovations to promote health lifestyles as fundamental to health care delivery. The Academy through its work with members of the Health Behavior Expert Panel supported the United Nations High-Level two day meeting on Non-Communicable Diseases (NCDs) and urged the UN to include language in documents that encouraged nations to expand nursing capacity to address the prevention and treatment of NCDs and reduce risk factors by supporting expansion of nursing education, research, and promoting nursing leadership in policy development and implementation. Additionally, in 2011, Fellow Bernadette Mazurek Melnyk, PhD, RN, CPNP/PMHNP, FNAP, FAAN, led a panel discussion, America's Children in Peril: Solving the Obesity and Mental Health Epidemics, addressing the commonalties between mental and physical health problems among adolescents.
Quality
Six substantive position papers are being written including: Measuring Episode of Care Outcomes, Measuring Care Coordination; Measuring the Economic Value of Nursing; Measuring Nurses' Workload; Measuring Patient Engagement; and, Harmonizing Performance Measures - Implications for Practice, Education and Research. The Academy endorsed the formation and goals of the Nursing Alliance for Quality Care (NAQC) as one strategic element to transform care recognizing that nurses are at the front lines of care delivery and, increasingly, help to design, implement and evaluate the care systems and related outcomes. Fellow Gerri Lamb, PhD, RN, FAAN, was named Vice Chair of NAQC.
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