Madrean Schober Strategic Planning for Advanced Nursing Practice

Madrean Schober Strategic Planning for Advanced Nursing Practice 1 Introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 1.1 Defining Strategy and Strategi ...

Madrean Schober Strategic Planning for Advanced Nursing Practice 1 Introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 1.1 Defining Strategy and Strategic Planning. . . . . . . . . . . . . . . . . . . . . . 1 1.2 Policy and Policy Theory Defined. . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 1.3 Significance of a Strategic Approach. . . . . . . . . . . . . . . . . . . . . . . . . . 4 1.3.1 Benefits to a Strategic Approach. . . . . . . . . . . . . . . . . . . . . . . 5 1.3.2 Limitations to a Strategic Approach. . . . . . . . . . . . . . . . . . . . 5 References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 2 Strategic Planning for Advanced Nursing Practice. . . . . . . . . . . . . . . . . 9 2.1 Key Factors to Consider in Exploring the Possibilities for an Advanced Nursing Practice Initiative. . . . . . . . . . . . . . . . . . . . 9 2.2 Defining the Policy Process. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 2.2.1 Agenda Setting. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 2.2.2 Policymakers and Their Networks. . . . . . . . . . . . . . . . . . . . . . 12 2.2.3 Influencing Policy Decisions. . . . . . . . . . . . . . . . . . . . . . . . . . 13 2.2.4 Nurses’ Participation in the Policy Process. . . . . . . . . . . . . . . 13 2.3 Frameworks for Implementation of Advanced Nursing Practice. . . . 15 2.3.1 PEPPA Framework. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 2.3.2 Schober Conceptual Policy Framework for Advanced Practice Nursing. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 2.3.3 Conceptual Policy Framework: Singapore Exemplar. . . . . . . 26 2.3.4 Additional Models/Frameworks for Advanced Nursing Practice. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31 3 Theories of Social and Healthcare Policy. . . . . . . . . . . . . . . . . . . . . . . . . 35 3.1 Hall, Land, Parker, and Webb Agenda-Setting Framework. . . . . . . . . 35 3.1.1 Legitimacy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36 3.1.2 Feasibility. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36 3.1.3 Support. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36 3.2 Kingdon’s “Windows of Opportunity”. . . . . . . . . . . . . . . . . . . . . . . . 37 3.3 Lindblom’s Incrementalism and Disjointed Incrementalism. 3.3.1 Disjointed Incrementalism. . . . . . . . . . . . . . . . . . . . . . . . . . . . 39 3.3.2 Strengths and Limitations of Incrementalism. . . . . . . . . . . . . 40 3.4 Walt’s Framework for Policy Implementation. . . . . . . . . . . . . . . . . . . 41 3.4.1 Principles of the Walt Framework. . . . . . . . . . . . . . . . . . . . . . 41 3.4.2 The Policy Process According to Walt. . . . . . . . . . . . . . . . . . 42 3.4.3 Implementation: Do Those Who Implement Policy Decide Policy Formulation?. . . . . . . . . . . . . . . . . . . . . 43 3.4.4 Walt’s Strategy for Policy Implementation. . . . . . . . . . . . . . . 44 3.5 A Comparison of Theories of the Policy Process. . . . . . . . . . . . . . . . 44 3.6 Commentary on the Relevance of Policy Theory for Nursing. . . . . . . 45 References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 4 Evidence-Based Policy Decisions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49 4.1 Reality: Is Evidence Used to Make Policy Decisions?. . . . . . . . . . . . 49 4.2 Policy Agenda Setting and Policy Decisions: Frameworks and Models. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51 4.2.1 Key Decision-Makers: Power and Authority. . . . . . . . . . . . . . 53 4.2.2 Participation in the Policy Process: Direct and Indirect. . . . . 54 References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56 5 Politics: The Art of Diplomacy and Negotiation. . . . . . . . . . . . . . . . . . . 57 5.1 Nurses’ Stages of Political Engagement. . . . . . . . . . . . . . . . . . . . . . . 57 5.2 Acquiring the Necessary Skills. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59 5.2.1 Leadership Competencies. . . . . . . . . . . . . . . . . . . . . . . . . . . . 59 References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62 6 Effective Change: A Strategic Approach. . . . . . . . . . . . . . . . . . . . . . . . . 65 6.1 Assessment of the Healthcare Environment. . . . . . . . . . . . . . . . . . . . 65 6.1.1 Scanning the Environment. . . . . . . . . . . . . . . . . . . . . . . . . . . . 66 6.1.2 SWOT (Strengths, Weaknesses, Opportunities, Threats) Analysis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67 6.1.3 Stakeholder Analysis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68 6.2 Regulation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69 6.2.1 SSPP Model (Scope, Standards, Policies, and Procedures). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70 6.2.2 Non-medical Prescribing in the United Kingdom (UK): Policy and Legal Strategy. . . . . . . . . . . . . . . . . . . . . . . . . . . 71 6.2.3 Nurse Prescribing: A Global Role Analysis. . . . . . . . . . . . . . 80 6.3 Introducing Advanced Practice Nurses: A Process. . . . . . . . . . . . . . . 84 6.3.1 The Nurse Practitioner in New Zealand: Legislation and Process. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84 6.3.2 Transition Experiences of Nurse Practitioners in Australia. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 88 6.3.3 Advanced Nursing Practice Strategy and Policy in Germany. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91 6.3.4 The Netherlands: Process, Legislation, and Evaluation. . . . . . 92 6.4 Influencing the Process: Beneficial Debate and Discussion. . . . . . . . 97 6.5 Research and Evaluation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98 6.5.1 Dissemination of Empirical Findings and Information. . . . . . 99 Appendix 6.1: SWOT Analysis Matrix Template. . . . . . . . . . . . . . . . . . . . 101 Appendix 6.2: SWOT Analysis Matrix Illustration. . . . . . . . . . . . . . . . . . 102 Appendix 6.3: Global Nurse Prescribing by Role Descriptor. . . . . . . . . . . 103 References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 104 7 Policy Analysis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 109 7.1 Process and Models. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 109 7.1.1 Policy Analysis Models. . . . . . . . . . . . . . . . . . . . . . . . . . . . 111 7.2 Indicators and Outcomes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 112 7.3 Evaluation and Adaptation: Population Indicators. . . . . . . . . . . . . 113 7.4 Determining the Correct Path to Follow. . . . . . . . . . . . . . . . . . . . . 113 References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115 8 Rational Policy Decision-Making: Idealism Versus Realism. . . . . . . 117 8.1 Policy-Making: A Rational Process. . . . . . . . . . . . . . . . . . . . . . . . . 117 8.2 Incrementalism and Policy Decisions. . . . . . . . . . . . . . . . . . . . . . . 119 8.3 A Debate: Rational Change Versus Disjointed Incrementalism. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 120 8.3.1 Assumptions of the Rational Decision-Making Model. . . . 120 8.3.2 Incrementalism and Disjointed Incrementalism. . . . . . . . . 121 References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 123