Sample Nursing Research Paper on Advanced Practice Nursing and Healthcare Policy

Health systems around the world are rapidly changing and developing. Registered nurses (RNs), as a key component of this system, should move along with these changes. Consequently, RNs ought to influence the formulation of health policies rather than just waiting to implement them. Since nurses spend considerable time with patients, they are aware of the specific needs of the society they serve. As such, RNs are excellent advocates for healthcare policy development.

History of Policy Development and Policy Making In Nursing

Just 15 to 20 years ago, it was hard to find health policy as part of nursing education content or practice expectations. In the last two decades, however, researchers have focused on establishing the relationship between healthcare policy and nursing. The American Association of Colleges of Nursing (AACN) saw the need to include health policy as a component of APNs Master’s education program as a way of promoting nurses’ involvements in policy making and development (Burke, 2016). Similarly, nurses have authored several books on health policy. Through such publications, education venues, political activism, and professional organizations, nurses have increased their stake as critical health policymakers.

Different Types of Policy and Their Relationships to Healthcare Policy

There are different types of policies, all of which are related to healthcare policy. The common types of policies include substantive, distributive, redistributive, capitalization, and regulatory policies. Substantive policies concern themselves with general welfare and development of society. Regulatory policies focus on the regulation of businesses and focus on the implementation of safety measures (Burke, 2016). Distributive policies concern themselves with extending goods and services to the public, while capitalization policies seek to provide financial subsidies to the public. Healthcare policies focus on providing the best service and care delivery to society at the most affordable prices and in the most efficient manner possible (Houskova, 2018). As such, considering all these policies, the key objective is to better the welfare of citizens through cost-effective service delivery.

Current Barriers to Practice for Advanced Practice Nurses

Current barriers to practice for APNs in the United States include variations within the states concerning the scope of practice, collaborative requirements, and authority; lack of job satisfaction and intention to leave practice among some RNs; restrictive payer policies that limit APNs’ ability to independent practice; and challenges in creating optimal collaboration between RNs and physicians.

Practice barriers for APNs in Ohio

Certain serious barriers prevent APNs from implementing evidence-based practices that greatly improve patient outcomes in Ohio. While some of these challenges are central to the state, most of them are shared across the national level (Mohsen, Safaan & Okby, 2016). Top among these barriers include resistance from nursing leaders, organizational and political cultures that do not encourage change, and lack of organizational support (Peterson, 2017). At the national level, barriers, such as lack of support from managers, hinder young APNs from implementing evidence-based approaches to care as the older generations tend to resist change. Such barriers are also prevalent in Ohio.

Forms of Competition on State and National Level That Interfere with Advanced Practice Nurse’s Ability to Practice Independently

Some forms of competition between state and national levels interfere with APNs’ ability to practice independently.  Such restrictive regulations are a serious hindrance to APNs’ ability to apply evidence-based in healthcare delivery, thus limiting their scope (Stavor, Zedreck-Gonzalez, & Hoffmann, 2017).APNs with the same certification and educational programs may face many restrictions when moving from one state to Ohio and vice versa. Such conflicting policies hinder accessibility to care.

The Lawmakers at the State Level (Ohio)

The Legislative Service Commission serves as the source for legal expertise in Ohio State. The agency drafts proposed legislation and assists in advertising to the general public on the Ohio Assembly’s happenings. The state’s legislature, Ohio General Assembly consists of 33 state members.  Larry Obhof is the current president of Ohio’s law-making body with Kenny Yuko being the Senate’s Minority leader (The Ohio State, 2020). During each legislative session, Democrat and Republican members-elect leaders responsible for setting policy priorities and agenda for their respective caucus.   Both houses meet at Columbus, Ohio’s statehouse for policymaking. Ohio state governor, a position currently held by Mike DeWine, also plays a critical role in the state’s policymaking. The state is represented in the U.S. House of Representatives by 16 congressmen and congresswomen who help in spearheading the state’s interests in the federal government.

Interest Groups That Exist At the State (Ohio) and National Levels That Influence Advanced Practice Nursing Policy

Different interest groups influence APN policy both at Ohio State and at the Federal level. Key among these groups are professional organizations, such as AACN, government agencies such as the general assembly, and patient groups that demand policy change and better services.

Methods Used To Influence Change in Healthcare Policy in Forms of Competition, Ohio Legislative and Executive Branches of Government and Interest Groups

Various methods are used to influence change and development in healthcare policy both at the state and nation level. For instance, the Federal Trade Commission (FTC) promotes competition in healthcare, thus benefiting consumers through cost and price control, promotion of innovative products and services, and improvement of care (Burke, 2016). Ohio legislative and executive branches also promote healthcare policy change through advocacy. Interest groups, such as AACN, arm nurses with empirical policy knowledge and necessary practical tips on how to foster change in nursing policy frameworks.




Burke S.A. (2016). Influence through policy: Nurses have a unique role. Reflections on Nursing Leadership.

Houskova, M. (2018). “Nursing Engagement in Policy Development and Advocacy” (2018). DNP Qualifying Manuscripts. 11.

Mohsen, M. M., Safaan, N. A., & Okby, O. M. (2016). Nurses’ perceptions and barriers for adoption of evidence-based practice in primary care: Bridging the gap. American Journal of Nursing Research4(2), 25-33.

Peterson, M. E. (2017). Barriers to Practice and the Impact on Health Care: A Nurse Practitioner Focus. Journal of the advanced practitioner in oncology8(1), 74.

Stavor, D. C., Zedreck-Gonzalez, J., & Hoffmann, R. L. (2017). Improving the use of evidence-based practice and research utilization through the identification of barriers to implementation in a critical access hospital. JONA: The Journal of Nursing Administration47(1), 56-61.

The Ohio State. (2020). Senators | The Ohio Senate. Retrieved 8 July 2020, from