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Policy, Economics, and Legal Aspects of Nursing

The Importance of Staying Up to Date with Federal and State Health Policies

Healthcare is a professional area where compliance with up to date standards and policies influences the safety and effectiveness of a caregiver’s work. Such policies can be divided into federal and state laws: in the US, federal laws are created by Congress, while state laws are issued by state legislations. A nurse is supposed to demonstrate high professionalism and discipline to ensure the safe and high-quality provision of medical services (Yoost & Crawford, 2019). Moreover, health policies can also be used to evaluate a nurse’s professional skills.

One of the main reasons for staying informed about current federal and state health policies is that it can protect both the patient and the nurse. In the first case, health policies regulate procedures performed by caregivers and minimize the risk of malpractice. In the second case, they ensure safe and comfortable conditions for a nurse’s work. Such standards and regulations may also be helpful in disputable situations between nurses and patients.

Resources to Stay Up to Date

In order to be aware of up to date health policies, nurses need to expand their knowledge and regularly consult with medical sources, such as journals and official documents. Accreditation standards established by different organizations, such as Commission for Nursing Education Accreditation and The Joint Commission, can be used as examples (Yoost & Crawford, 2019). Moreover, since standards of care are defined for each niche specialization, a nurse may consult scientific journals in a particular nursing area.

Participation in professional organizations can also be a way to follow the changes in nursing policies. For example, the American Nursing Association and the National League for Nursing are some of the most well-known nursing organizations (Yoost & Crawford, 2019). By connecting with other practicing nurses, caregivers may be aware of the current policies and exchange professional experience with colleagues from different parts of the country.

Ways Nurses Can Get Involved in the Policy Process

In all areas of healthcare, it is essential to comply with specific rules and regulations. They do not only standardize nurses’ practice but also help resolve disputable cases. Policies and regulations are not limited to clinical settings: they are used as a benchmark to evaluate nurses’ professional skills (Yoost & Crawford, 2019). Therefore, licensure and accreditation are other areas demonstrating how nursing policies can be used.

In addition, nurses themselves can be involved in a policy-making process. For example, Salvage and White (2019) suggest that nurses’ leadership is a modern tendency of healthcare. For example, various leadership campaigns and programs, such as Nursing Now, are aimed at developing strategic and policy leadership among nurses. Directly involved in healthcare practices, nurses can suggest better ideas than the members of parliaments and boardrooms, who may not be aware of the real needs of healthcare workers.

Key Economic Principles for Nursing

Nurses’ awareness of the economic effect of their actions has always been a sign of their professionalism. According to Friberg (2019), nurses constitute the biggest number of healthcare workers, and therefore, play an essential role in influencing the effective use of healthcare resources. Indeed, since healthcare costs are a significant portion of the overall economy, it is necessary to understand the main economic principles and incorporate them in clinical practice.

The most important role of economic principles is to regulate the rational distribution of resources in nurses’ practice. Firstly, a nurse should provide care “in the most cost-effective manner” (Friberg, 2019, p. 111). Secondly, the principles of economics can be used to understand the demands of consumers and the ways to satisfy these needs. Finally, nurses can work towards the improvement of the quality of their services and ensure the equal distribution of resources in the sphere of healthcare (Friberg, 2019). Understanding these basic principles, nurses can contribute to managing the economic situation of the healthcare institution.

Concepts of HCACPS Scoring and CMS Payment

Patient satisfaction is an important criterion demonstrating the quality of provided care. The experience of people using medical services is measured by a specially focused survey – The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). The survey has 32 questions about particular aspects of clinical care, screening, communication with doctors and nurses, and the overall satisfaction by the healthcare facility (Shalowitz, 2019). At the same time, the survey is generalized and does not include questions about more specialized procedures.

The results of the survey are used later by CMS to pay hospitals. Payments and reimbursements are made according to the overall level of satisfaction demonstrated by patients (Shalowitz, 2019). Therefore, a professional nurse should understand the role that patient experience plays in the healthcare system. Addressing the needs of people using medical services and promoting high-quality care is the way to increase patient satisfaction and influence payments.

Ways Nurses Can Be Steward of Resources

As it was emphasized previously, the financial foundation of healthcare institutions directly depends on the efficiency of nurses’ work. According to Jones et al. (2018), nurses can be held accountable for both expenses and revenues related to healthcare. In particular, patient satisfaction and the results of HCAHPS scoring define the amount of payment to the hospital. Therefore, high-quality care and wise allocation of limited resources can lead to an increase in revenue.

Similarly, adverse events, conflicts, and mistakes can result in penalties and additional expenses. In order to control them, nurses can take part in evaluating the revenues and costs of a healthcare organization and planning the budget. Besides paying attention to the quality of their work, they can assist the medical organization by sharing their opinions with nurse managers about how to maintain the prevalence of revenues over expenses.

Revenue Sources, Budgeting, and Professional Nursing

Revenues in nursing should be enough to cover all healthcare-related costs and provide a profit. One of the most common sources of revenue is amounts received from patients or third parties, for example, insurance companies (Jones et al., 2018). Other revenue sources include grants and unions, managed care organizations, city administration, and professional corporations (Jones et al., 2018). It is important to remember that patient dissatisfaction and low quality of nurses’ work can decrease revenues.

The nursing budget depends on the needs of the previous fiscal year. It includes staff costs, such as employees’ salaries, business supplies, and resident supplies (Jones et al., 2018). A professional nurse knows that the budgeting of nursing depends on the entire work of the healthcare institution and the efficiency of the use of its financial resources. Moreover, a healthcare worker should understand the importance of planning the budget, as well as evaluating previous financial reports.

Principles of Malpractice

Malpractice refers to different kinds of negligence committed by a professional. In nursing practice, it includes unethical behavior, deficiency of professional skills, and failure to meet the standards of safe healthcare (Yoost & Crawford, 2019). Some examples of malpractice are prescribing the wrong medication to a patient, insulting patients, and calculating the inaccurate dosage of medication. Therefore, a professional nurse should be aware of what is considered malpractice and should be avoided in clinical practice.

Best Practices for Avoiding Nursing Malpractice

There are several ways to avoid or minimize nursing malpractice in clinical settings. Yoost and Crawford (2019) recommend maintaining professional practice knowledge, constantly improving professional skills, and paying attention to relationships with patients and their families. Moreover, it is important to maintain confidentiality, comply with legal and ethical guidelines when sharing information or conducting procedures, and follow the requirements of safe nursing practice of a particular healthcare institution.

Besides taking into consideration nurses’ professional skills, it is necessary to ensure their legal support. For example, nursing students are supposed to be covered by malpractice insurance of the educational institution. Moreover, nurses need to know the exact elements of malpractice, such as damages incurred and the responsibility of a nurse on duty. If these characteristics are present, it is possible to conclude that malpractice took place; otherwise, a nurse is able to plead not guilty.

State Board of Nursing’s Disciplinary Process and Nursing Practice Standards

Disciplinary processes of the State Board can differ according to the state where they occur. The disciplinary process includes investigating the case and defining whether the proceedings should be formal or informal and what kind of action (emergency or disciplinary) should be taken. Each state’s Nursing Practice Act (NPA) contains reasons and conditions for disciplining a nurse (Masters, 2018). For example, it includes a list of nurses’ actions demanding a disciplinary response from the Board. Some states can amend their NPAs and issue state-specific regulations. For instance, in Minnesota, it is unethical for a non-registered caregiver to use the title “nurse.” As for nursing practice standards, ANA can be considered the resource of professional requirements for nurses (Masters, 2018). These standards clarify licensure and certification of nurses and regulate assessment, diagnosis, treatment, and other procedures.


Friberg, E. E. (2019). Conceptual foundations: The bridge to professional nursing practice (7th ed.). Elsevier Health Sciences.

Jones, C., Finkler, S. A., Kovner, C. T., & Mose, J. (2018). Financial management for nurse managers and executives (5th ed.). Elsevier Health Sciences.

Masters, K. (2018). Role development in professional nursing practice. Jones & Bartlett Learning.

Salvage, J., & White, J. (2019). Nursing leadership and health policy: everybody’s business. International Nursing Review, 66(2), 147–150. doi:10.1111/inr.12523

Shalowitz, J. I. (2019). The U.S. healthcare system: Origins, organization and opportunities. Jossey-Bass.

Yoost, B. L., & Crawford, L. R. (2019). Fundamentals of nursing: Active learning for collaborative practice (2nd ed.). Elsevier Health Sciences.

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