Discuss the process of policy agenda setting in health. Discuss and analyses the process of agenda setting in the health sector.

Discuss the process of policy agenda setting in health. Discuss and analyses the process of agenda setting in the health sector.

In healthcare systems, the role of healthcare policy in shaping the quality, availability, and safety of the healthcare services provided to patients is important. Nurses are at the front lines with the patient and understand the concerns that affect the health of the patient and the health care system; therefore, they have a unique opportunity to make a difference in the area of health care policy. The greatest problem in health care is lack of nurses, and the use of a general or not patient-specific nurse to patient ratio. In many health care facilities, there are health care professionals, more specifically nurses, whose job responsibilities are based on the number of patients; and consequently, there is an excessive amount of burn out amongst the staff, more specifically the nurses, excessive medical errors, lower patient satisfaction, and lower clinical outcomes. An acuity-based nurse staffing model has more merit as it uses the acuity of patients and the nursing care needed to determine the number of nurses to be assigned. This paper will look at the issue of inadequate staffing of nurses in healthcare, discuss which administrative agency would be best suited to tackle the issue, and propose a way to present the issue to the President, followed by an explanation of how nursing advocacy and leadership can help bring about a change in policy addressing the issue of inadequate staffing (Milesky et al., 2025).

Explain the health problem in the health care setting. Describe a health issue in health care.

The shortage of nurses had a major effect on patient safety, the quality of care and employment status of healthcare actors. Generally, traditional staffing models are based on a nurse-to-patient ratio, rather than on fluctuations in acuity. This may result in nurses performing their duties with insufficient manpower to meet patients’ very complicated medical needs. This imbalance results in fatigue, burnout, higher employee turnover and substandard nursing care. Always, when staffing is insufficient, there are consequences for the patient, such as medication errors, patient falls, hospital-acquired infection, mortality rates, and length of hospital stays, which all evidence shows as negative consequences. Further, with the scarcity of nurses, they are also subjected to emotional stress and job dissatisfaction (Peutere et al., 2023). Staffing Model based on patients’ needs is Evidence-based approach. This can help ensure optimal patient care, waste minimization and cost reduction. The significance of the problem is it affects a growing number of patients, a shrinking number of staff and increasingly complex health care. Addressing staffing concerns is an important aspect of quality health care systems and public health protection; policy makers must respond.

Administrative Agency Analysis

The Department of Health and Human Services (HHS) most likely is a department that would be responsible for solving a problem about insufficient nurse staffing. Other HHS agencies that are important for establishing standards for quality, safety and evidence-based healthcare practices include the Centers for Medicare and Medicaid Services (CMS) and the Agency for Healthcare Research and Quality (AHRQ). The best place to be is indeed HHS, because they are the ones that supervise national healthcare programs, formulate policies which affect the reimbursement of healthcare providers, quality improvement, in addition to patient safety regulations. CMS can be incorporated into hospital quality reporting and reimbursement by incorporating nurse staffing into safe staffing practices. Hospitals receiving Medicare or Medicaid reimbursements are very impacted by CMS policies and quality measures. Furthermore, AHRQ funds research into healthcare quality and patient safety, such as research on characteristics of nurse staffing and patient safety outcomes (Young & Smith, 2025). The nurse’s fatigue, nurse burnout, and high workloads can also be a workplace safety concern that needs to be addressed by Occupational Safety and Health Administration (OSHA). However, the primary responsibility for HHS remains unchanged as its mandate is more expansive in that respect, having a wider range of policy options to develop, fund and implement quality improvement programs in health care.

Media is not only a source of information but also sets the agenda as well as the focus of President’s attention.

The issue of understaffing of nurses could be brought onto the Presidential agenda due to increased awareness, health care research, advocacy and media attention. Based on Kingdon’s agenda-setting theory, for a health care problem to be politically salient the political stream, the policy stream and the problem stream must converge. The nurse staffing problem is evident, as evidenced by the high rate of nurse burnouts, lack of nurses from the COVID-19 pandemic and the proven link between nurse staffing and patient outcomes. It is evident that the issue stream is ongoing as there are still ongoing hospitals-wide employee shortages that pose a threat to patient safety and the quality of healthcare. The policy stream is warranted by existing solutions to the issues (e.g. acuity-based staffing models) that are being proposed in healthcare research. Lobbying is a part of the political stream: Advocacy groups and unions, and healthcare institutions and nursing organizations, try to get the attention of policy makers and politicians about staffing reform (Hoefer, 2022). The media and public interest can also be a factor in getting the issue onto the presidential agenda. More people are becoming aware of the issues of overcrowding, nurse strikes, and preventable harm to patients, thus putting more pressure on the public and the political agenda for healthcare reform. Moreover, insufficient personnel in the health care sector will affect the national economy, the cost of health care, and access to health care—all President Bush’s priority issues. Continuing advocacy, research and public discussion is needed to maintain the issue in the presidential agenda. Political pressure can be exerted through lobbying by professional nursing groups, such as the American Nurses Association (ANA) and American Association of Critical-Care Nurses (AACN) through policy campaigns and influencing policy makers/legislative bodies.

This individual will be the Policy Entrepreneur or Policy Champion.

The American Nurses Association (ANA) would make a good policy entrepreneur or a nurse champion on the issue of nurse staffing. ANA is a national nonprofit professional nursing association and is a leading voice in the advocacy of health care policy in the United States. The group is a strong proponent of safe staffing policies, protections for the nurse workforce and evidence-based health care policies. The ANA would be the perfect champion because it is a voice of the nurses throughout the country and can have an influence on the policies and the public. The ANA can contribute to the advancement of the use of acuity-based models for staffing and safer staffing policies through research, advocating for legislation, and public education campaigns. Frontline nurses can also be great advocates by sharing their experiences around the issues of staffing and violations of patient safety. Real-life scenarios in healthcare can be very influential in policymakers’ perceptions of the impact of understaffing.

The part of Nurses in Policy Advocacy

Part of the nurses’ role in healthcare policy advocacy is that they have firsthand knowledge of the challenges and inefficiencies of patient care in the healthcare system. Healthcare professionals (including nurses) may be active in their professional association, legislative advocacy, research and education, and public education to effect healthcare reform. APRNs are important in policy development, in particular, due to their ability to bring evidence-based practice skills and clinical expertise to the table. APRNs have the opportunity to advocate for policies that will contribute to improved staffing, patient safety and quality of care (QOL) (Bakerjian, 2022). Politics engage nurses since policies impact nursing practice, care and access to care. Nurses have a role to be a voice at policy level discussions where they can influence the development of clinical evidence-based, patient-centered policies. Advocacy activities can involve attending legislative hearings and joining professional organizations, community education, and helping with evidence-based policy initiatives.

Conclusion

Low nurse staffing is one of the most frequent healthcare issues that has a significant impact on patients’ safety, quality of healthcare and nurse wellbeing. The “old fashioned” type of staffing model is inefficient, does not take into account patient acuity and can result in poor patient outcomes, medical errors, and burnout. An acuity-based staffing model is an evidence-based model and is related to patient acuity. The Department of Health and Human Services has a variety of programs and policies it can use to address the challenge, such as establishing standards for healthcare quality, reimbursement, and patient safety. The question can be brought up in public forums, research, media and/or political pressure from professional organizations to the President. Because of their leadership and advocacy efforts in the nursing profession and in health care reform, the American Nurses Association is an appropriate policy champion. The nurse’s voice is required to continue the conversation about health/care policy and advocacy and to ensure that the solutions being advanced can come to fruition in evidence-based care and policies that can improve the health/care system. Nurses can make a difference when they are involved in policy development and politics, in making a healthier and safer health care environment for both patients and health care providers.

References

Bakerjian, D. (2022). The Advanced Practice Registered Nurse Leadership Role in Nursing Homes. Nursing Clinics of North America, 57(2), 245–258. https://doi.org/10.1016/j.cnur.2022.02.011

‌Hoefer, R. (2022). The Multiple Streams Framework: Understanding and Applying the Problems, Policies, and Politics Approach. Journal of Policy Practice and Research, 3(1), 1–5. https://doi.org/10.1007/s42972-022-00049-2

Milesky, J., Rosen, M., Sharma, R., Zhang, A., & Bass, E. B. (2025, April). Acute Care Nursing Staff Shortages That Compromise Patient-to-Nurse Ratios. Nih.gov; Agency for Healthcare Research and Quality (US). https://www.ncbi.nlm.nih.gov/books/NBK615419/

Peutere, L., Terho, K., Pentti, J., Ropponen, A., Kivimäki, M., Härmä, M., Krutova, O., Ervasti, J., Koskinen, A., & Virtanen, M. (2023). Nurse Staffing Level, Length of Work Experience, and Risk of Health Care–Associated Infections Among Hospital Patients. Medical Care, 61(5), 279–287. https://doi.org/10.1097/mlr.0000000000001843

Young, M., & Smith, M. A. (2025, February 24). Standards and Evaluation of Healthcare Quality, Safety, and Person-Centered Care. Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK576432/

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NURS_6050_Agenda
son Grid
.doc
LEARNING RESOURCES
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Page
3
Required Readings 
Administration
Which administrative agency
(like HHS, CDC, FDA, OHSA)
would most likely be
responsible for helping you
address the healthcare issue
you selected? Why is this
agency the most helpful?
of 4
ZOOM
Short, N. M. (2022). Milstead’s health policy and politics: A nurse’s guide (7th ed.). Jones &
Bartlett Learning.
Chapter 1, “Informing Public Policy: An Important Role for Registered Nurses” (pp. 2–23
only)
Chapter 3, “Problem Identification and Agenda Setting: What Rises to a Policymaker’s
Attention?” (pp. 57–71)
Chapter 10, “Financing Health Care” (pp. 229–239)
Chapter 12, “An Insider’s Guide to Engaging in Policy Activities” (pp. 293–301)
Centers for Disease Control and Prevention (CDC). (2024, May 15).
How do you think your selected
social media resources
healthcare issue might get on
Diabetes: Web and
the presidential agenda? How
(https://www.cdc.gov/diabetes/communication-resources/?
CDC_AAref_Val=https://www.cdc.gov/diabetes/library/factsheets.html) .
does it stay there?
Who would you choose to be
the entrepreneur/
https://www.cdc.gov/diabetes/communication-resources/?
CDC_AAref_Val=https://www.cdc.gov/diabetes/library/factsheets.html
Kingdon, J. W. (2001). A model of agenda-setting with applications.
D.C.L
champion/sponsor (this can be
a celebrity, a legislator, an
agency director, or others) of
Law Review M.S.U.
(https://go.openathens.net/redirector/waldenu.edu?
url=https://advance.lexis.com/api/permalink/9b2f387e-9503-4fed-8a60-f8f029778dfd/?
context=1516831) ., 2(331).
the healthcare issue you
selected? An example is
Michael J. Fox a champion for
Parkinson’s disease.
Smith, L., Roberts, K. J., Giambra, B., Polfuss, M., Danford, C., Sheppard-Lemoine, D.,
Schultz, T. R., Winter, N., Mulcaster, A., Alrimawi, I., Honda, J., Brysiewicz, P., Carr, S., &
Feetham, S. (2025).
Nurses’ engagement in healthcare policy development: An umbrella
review
(https://onlinelibrary.wiley.com/doi/10.1111/inr.70109) . International nursing
Global Navigation.
review, 72(4), e70109. https://doi.org/10.1111/inr.70109
Rosenthal L. D. (2024).
Political engagement to support, advocate, and advance APRN
© 2021 Walden University, LLC
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practice
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You will find this global navigation bar on every page in your
Canvas environment, to provide quick access to the most
utilized tools, outside of a course.
to-Support-Advocate-and) . AACN advanced critical care, 35(1), 18–19.
https://doi.org/10.4037/aacnacc2024900
OASIS. (n.d.).
Evaluate resources
(https://academicguides.waldenu.edu/library/evaluating)
. Walden University. https://academicguides.waldenu.edu/library/evaluating
Mood, L. H., Snyder, M. A., & Pope, A. M. (Eds.). (1995).
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Nursing, health, and the
environment
(http://ebookcentral.proquest.com/lib/waldenu/detail.action?docID=3376382) .
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USA.gov. (n.d.).
A-Z index of U.S. government departments and agencies
(https://www.usa.gov/agency-index) . https://www.usa.gov/agency-index
USA.gov. (n.d.).
Other links may also appear here, depending on what your
institute has deployed.
To find out more:
Branches of the US government
(https://www.usa.gov/branches-of
government) . https://www.usa.gov/branches-of-government
How do I use the Global Navigation Menu as
a student?
The United States Government. (n.d.).
The Cabinet.
(https://community.canvaslms.com/t5/Student
Guide/How-do-I-use-the-Global-Navigation-Menu-as-a-student/ta
p/522)
(https://www.whitehouse.gov/administration/the-cabinet/) The White House.
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https://www.whitehouse.gov/administration/the-cabinet/
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APA Course Paper Template (APA 7) (Word document)
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Agenda Comparison Grid Template (Word document)
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Respond to the Assignment Prompt
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Paraphrase and Summarize Information
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Locate, Cite, and Reference Journal Articles
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learning-resources)
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(https://academics.waldenu.edu/writing/organize
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