Assignment: Advocating for the Nursing Role in Program Design and Implementation

Assignment: Advocating for the Nursing Role in Program Design and Implementation
NURS – 6050C: Policy and Advocacy for Improving Population Health
Advocating for the Nursing Role in Program Design and Implementation
For the past three decades, there has been a significant shift in the U.S. approach to health care from the biomedical healthcare model to the biopsychosocial framework of comprehending well-being states and illness, especially for patients with chronic diseases (Aggar et al., 2021). In the last decade, newer interventions focusing on the social constituent of care have emerged, including the introduction of health coaches, walking groups, physical activity/exercise on prescription, art on prescription, and social prescribing, with some empirical evidence of behavioral transformation (Carnes et al., 2017). The above social prescription programs are designed to allow patients to enhance their self-care skills, mitigate complications, and play a role in tackling health inequities by establishing social support networks (Alliance for Healthier Communities, n.d.). The design and implementation of social prescription programs call for collaborative efforts among clinicians. Recently, TGK Hospital introduced music on prescription program at their Annex site in Atlanta. I interviewed the nurse executive manager (NE) of the hospital to establish the nursing role in the program design and implementation, and presented in this paper is the interview transcript showing the NE’s responses to specific questions about the program Assignment: Advocating for the Nursing Role in Program Design and Implementation.
ORDER HERE
Interviewer: Tell us about a healthcare program, within your practice. What are the costs and projected outcomes of this program?
 Interviewee: Social prescription is an inventive advance that targets to connect primary care patients with social support sources in the voluntary sector and within communities to aid them to improve their wellbeing, health, and care encounters (Pescheny et al., 2018). It offers our medical staff a non-clinical referral alternative, which runs beside clinical therapies, to tackle non-medical elements perpetuating and precipitating diseases and regularly result in frequent hospital visits. We have implemented music on prescription, and so far, it has enabled physicians, advanced nurse practitioners, and other interdisciplinary staff to officially refer elderly patients to community-based music programs (Pescheny et al., 2018). The estimated cost of the program is approximately $45,000/year, with the projected outcomes including improvements in general, mental, and emotional wellbeing, improved quality of life, and alleviated levels of anxiety and depression (Husk et al., 2019). The above will reduce hospitalization costs and allow our staff to focus on clinical cases.
Interviewer: Who is your target population?
Interviewee: The music on prescription program at TGK Hospital targets primarily elderly patients diagnosed with chronic illnesses, including Alzheimer’s dementia, cancer, pain, and those with depression with or without suicidal ideations.
Interviewer: What is the role of the nurse in providing input for the design of this healthcare program? Can you provide examples?
Interviewee: Available empirical have shown that in hospitals where social prescribing is a common practice, patients with chronic ailments receiving music on prescription feel less isolated, made 38% fewer emergency department units, and 47% fewer hospital visits (Aggar et al., 2021; Philip et al., 2019). Despite the above benefits, the uptake has remained relatively low mainly due to the failure to include nurses in the design and execution of the programs. Registered nurses (RNs) serve pertinent roles in guaranteeing the efficacy of the novel type of healthcare. RNs are already taking care of geriatric patients with chronic illnesses. Consequently, they can assist in identifying the patients at risk of social isolation and those qualifying for social prescription interventions (Pescheny et al., 2018).
Interviewer: What is your role as an advocate for your target population for this healthcare program? Do you have input into design decisions? How else do you impact design?
Interviewee: My specialty of practice is geriatric nurse practitioner, and I have worked with elderly patients for more than two decades. Through my long working experience, I have noted that a large share of my patients was experiencing feelings of loneliness, which substantially contributed to chronic depression and suicidal ideations, particularly those with Alzheimer’s dementia (Aftab & Shah, 2017; Ward et al., 2020). Thus, I took part in the search for evidence-based practice to mitigate suicidal thoughts in the abovementioned population and used the findings to push for the adoption of music on prescription programs at the hospital level. I attended a social prescription workshop in the U.K in early 2019, where I acquired knowledge on the design of the programs. Besides steering the interdisciplinary team involved in the design and implementation of the initiative, I am also a trainer of the frontline linking workers for the program Assignment: Advocating for the Nursing Role in Program Design and Implementation.
Interviewer: What is the role of the nurse in healthcare program implementation? How does this role vary between the design and implementation of healthcare programs? Can you provide examples?
Interviewee: RNs not only have the requisite skills, knowledge, and competencies to facilitate referrals but also the community connections to establish the services and groups that align with patients’ interests and preferences. Thus, while at the design stage their role was limited to developing proposals touching on the screening procedures of patients who are likely to profit from the program, RNs serve as champions, network events to share best practices and ensure collective understanding of the program, and facilitate the integration of the initiative into the hospital’s healthcare system (Pescheny et al., 2018). In particular, RNs help in the evaluation of the program by continuously mapping the attainment of the program outcomes vis-à-vis implementation goals.
Interviewer: Who are the members of a healthcare team that you believe is most needed to implement a program? Can you explain why?
Interviewee: Music on prescription is a broad initiative involving a diversity of stakeholders from various disciplines, including the hospital, patients, and community-based music providers. In the above view, the requisite members of the healthcare team include the patients’ physicians, who are responsible for identifying non-medical music on prescription and prescribing it to the patients (Alliance for Healthier Communities, n.d.). RNs and community-based assistant nurses are important in the program implementation as they link the patients to the appropriate social prescription program grounded on self-identified needs and interests, as well as support their self-care journey (Alliance for Healthier Communities, n.d.). Lastly, the hospital management committee facilitates the execution plan by facilitating the financial aspect of the program.
Conclusion
The objective of the paper was to examine the nursing role in the program design and implementation from the perspective of TGK Hospital’s NEs perspective through a one-on-one interview. From the interview transcript, it is apparent that TGK hospital has implemented music on prescription program. The above is a type of social prescription that offers a non-clinical referral alternative, which runs beside clinical therapies, to tackle non-medical elements perpetuating and precipitating diseases and regularly result in frequent hospital visits. The program targets elderly patients diagnosed with chronic illnesses. At the design level, RNs assist in identifying the patients at risk of social isolation and those qualifying for social prescription interventions. At the implementation stage, RNs help in the incorporation of the program into the hospital’s culture Assignment: Advocating for the Nursing Role in Program Design and Implementation
 
 
 
 
References
Aftab, A., & Shah, A. A. (2017). Behavioral emergencies: Special considerations in the geriatric psychiatric patient. Psychiatric Clinics of North America, 40(3), 449–462).  https://doi.org/10.1016/j.psc.2017.05.010
Aggar, C., Thomas, T., Gordon, C., Bloomfield, J., & Baker, J. (2021). Social prescribing for individuals living with mental illness in an Australian Community setting: A pilot study. Community Mental Health Journal, 57(1), 189. https://doi.org/10.1007/S10597-020-00631-6
Alliance for Healthier Communities. (n.d.). Social prescribing.  https://www.allianceon.org/Social-Prescribing
Carnes, D., Sohanpal, R., Frostick, C., Hull, S., Mathur, R., Netuveli, G., Tong, J., Hutt, P., & Bertotti, M. (2017). The impact of social prescribing service on patients in primary care: A mixed-methods evaluation. BMC Health Services Research, 17(1), 1–9. https://doi.org/10.1186/S12913-017-2778-Y/TABLES/5 Assignment: Advocating for the Nursing Role in Program Design and Implementation
Husk, K., Elston, J., Gradinger, F., Callaghan, L., & Asthana, S. (2019). Social prescribing: Where is the evidence? British Journal of General Practice, 69(678), 6–7. https://doi.org/10.3399/bjgp19X700325
Pescheny, J., Pappas, Y., & Randhawa, G. (2018). Social prescribing: Implementation and delivery. International Journal of Integrated Care, 18(s2), 214. https://doi.org/10.5334/ijic.s2214
Philip, K., Lewis, A., & Hopkinson, N. S. (2019). Music and dance in chronic lung disease. Breathe, 15(2), 116–120. https://doi.org/10.1183/20734735.0007-2019
Ward, M. C., Milligan, C., Rose, E., Elliott, M., & Wainwright, B. R. (2020). The benefits of community-based participatory arts activities for people living with dementia: A thematic scoping review. Arts & Health, 00(00), 1–27. https://doi.org/10.1080/17533015.2020.1781217 Assignment: Advocating for the Nursing Role in Program Design and Implementation