Introduction
Healthcare providers and organizations can influence the quality and achieve sustainable progress in the industry through policy implementation initiatives. Furthermore, administrative institutions support the development of novel regulations to help professionals improve their skills and operations. The IOM Future of Nursing Practice Report Brief published the recommendations that address the needs of populations, practitioners, and the industry in general (Academic Progression In Nursing, n. d.). One of their guidances explains the demand for continuing education for nurses because of the developing technologies and the expanse of skills necessary to maintain healthcare services at the appropriate level. Various policies have been established to enable nursing practitioners nationwide to keep upgrading their knowledge and qualification. The regulations also included the conditions for healthcare and academic organizations to support the workforce’s ability to study. This paper aims to analyze the policy related to the demand for continuing education for nursing practitioners and build a consensus about its implementation and effectiveness.
Defining The Policy Issue
The demand for nursing practitioners’ continuing education can be addressed through multiple regulations referred to academic institutions and healthcare organizations. The policy issue exists in the modern environment as professionals face workforce shortages, gaps in skills, and unavailability of qualification improvement courses. When the Affordable Care Act (ACA) was passed in 2010, the government included the programs such as additional licensing and practicum hours completion to stimulate continuing education (Shinners & Graebe, 2020). However, the inequity of academic organizations’ fulfillment and differences in programs created a significant nursing staff’s skillfulness gap. Along with the rapid technological development, which forces the professionals to keep studying and increasing their knowledge level, the difference between the practitioners’ preparation became a significant policy issue (Melnyk et al., 2018). Furthermore, the COVID-19 pandemic resulted in the healthcare workforce shortage, forcing the organizations to hire employees with low educational and practical levels. These conditions reveal the demand for addressing the policy issue of continuing education for nursing practitioners nationwide.
The Issue in The Policy Arena
The policy arena is affected by the difficulties of providing opportunities for nursing practitioners’ continuing education at all levels. Indeed, local organizations cannot provide sufficient quality services due to the skilled workforce shortage (Thies & Serratt, 2018). States cannot provide adequate funding for the facilities and academic institutions to deliver additional educational and practicum options. Furthermore, diverse licensing and certification regulations for nursing practitioners developed by local boards and the absence of a universal policy prevents professionals from getting jobs in different counties (Melnyk et al., 2018). The gap in workforce skillfulness has a nationwide impact on healthcare sector financing because how practitioners provide treatment directly influences the efficiency of the organizations and citizens’ wellbeing.
Stakeholders who represent the policy arena experience adverse outcomes of the lack of proper regulations to promote continuous learning and make it equally available. For instance, as a part of the proposal, the American Association of Colleges of Nursing (AACN) recommended the education system primarily rely on the state’s boards and requirements to provide them with an adequate workforce (Thomas et al., 2020). All policy arena representatives must be involved in developing and establishing proper and adjustable strategies to eliminate the gaps in the nursing practitioners’ skillfulness.
Current Politics
The current politics that address the lack of nursing continuing education regulations are based on the standards professionals must consider for getting a job at local healthcare organizations. They include the requirements of the practicum hours completion, minimum degree level to be employed, and the options to combine studying with working. Furthermore, the regulations are diverse depending on the state because the continuing education policies are developed by local boards and address the demands of specific areas. For instance, nursing requirements in New Jersey enable the practitioners to complete a one-hour course about tissue organ donation, while in New York, the three-hour infection control studying is mandatory (Online Continuing Education For Healthcare Professionals, 2021). The most current politics tend to lower the benchmarks for nursing practitioners to rapidly increase the number of employees necessary to combat the COVID-19 pandemic. Although it is beneficial for an emergency, it has severe long-term outcomes for the workforce’s skillfulness.
The Policy-Making Level
Policy-making for nursing practitioners’ continuing education is in the process of development; however, significant progress has already been achieved in academic programs and licensing regulations. The colleges and universities’ curriculums have been adjusted with the disciplines that encourage the students to keep learning and cultivate self-development (Crisp & Iro, 2018). The requirements to receive a license have become more strict, resulting in the need for more specific and complex education for future practitioners. Since the policy-making process to address nurses’ continuing education began with the Affordable Care Act establishment in 2010, the challenges such as the increasing gap in workforce preparedness occurred (Crisp & Iro, 2018). Consequently, today’s level of operations must be dedicated to achieving equity in the quality of skills received through academic and practical curriculums.
Policy Analysis
Policy analysis is a workable strategy to explore the contexts through which the problem of continuing education for nursing practitioners can be identified and addressed. Healthcare administrative organizations such as the Association for Healthcare Administrative Professionals (AHCAP) can develop facilities to improve the implementation of the supporting programs nationwide (Thomas et al., 2020). Indeed, social, ethical, legal, historical, financial, and theoretical aspects of regulations will provide sufficient evidence for further proposals and updates to achieve sustainable results.
Social Context
High-quality healthcare is required for society to thrive, and the level of practitioners’ education influences the services’ quality. Consequently, the policy that enables all stakeholders to advocate for continuous learning improvement will benefit all populations and create a foundation for other institutions to update their standards (Thomas et al., 2020). Furthermore, the social context of developing solid and universal regulations for continuing education reveals what the younger generations’ representatives should expect from the healthcare sector jobs.
Ethical Context
The ethical aspect of the policies to improve and regulate continuing education in nursing can be viewed from the practitioners’ and patient outcomes’ perspectives. Indeed, future professionals should have access to equally valued education and the ability to plan their careers. The educational organizations must consider the principles of integrity and trustworthiness in developing curriculums and by the workplaces in offering the qualification improvement options (Coleman et al., 2018). From the patient outcomes perspective, the considerations of beneficence and non-maleficence are vital to be applied, and a low level of practitioners’ skills can violate them.
Legal Context
In modern healthcare organizations, the law must protect patients and practitioners equally; however, the latter receive less juridical support. The policy issue of lacking opportunities and regulations for nursing continuing education can cause legal conflicts if, for instance, the completed practicum and disciplines’ studying would change in a specific state (Shinners & Graebe, 2020). The practitioners prepared following the older regulations might receive fewer job options than expected, and there is no law to assist them in getting subsiding for adjusting their educational level. Consequently, the juridical context of the issue reveals the need for specific legislation to benefit future professionals.
Historical Context
Professional nursing has always been valued in the American healthcare system, and receiving specialized education is a respected decision. The historical context of most academic organizations’ performance reveals the rapid growth of accessibility and quality of knowledge and experience (Stievano et al., 2019). Colleges and universities developed strong academic recognition, motivating students nationwide to enroll, and the American Association of Colleges of Nursing (AACN) has decision-making power in policy-making. However, the lack of appropriate policies to regulate the continuing education for practitioners threatens the quality and the authority of having a degree in nursing.
Financial Context
Continuing education initiatives depend on private and public funding as the academic and healthcare organizations need finances to support practitioners’ courses development and implementation. Academic learning is expensive in the United States, and future practitioners take loans to receive at least the lowest degree; thus, additional investment for supporting qualifications improvement is necessary (Thies & Serratt, 2018). From the patient outcomes perspective, economic context addresses the cost efficiency of healthcare providence. The quality of services depends on nursing workforce skills and performance, and if continuing education initiatives decline, the number of health issues will increase.
Theoretical Underpinnings of The Policy
The theoretical underpinning of the demand for implementing a policy to regulate the continuing education for nursing practitioners is the research about the additional courses’ efficiency. Indeed, recent studies suggest that the difficulties of resolving the education-related challenges reveal that the barriers for increasing the academic level exist and require policy-based solutions (Shinners & Graebe, 2020). Indeed, from a professional nursing perspective, the problems are financial shortage, lack of time, academic support, and motivation (Shinners & Graebe, 2020). Furthermore, the continuous technological progress and services advancement makes the need for continuing education essential, and policies must provide professionals with sufficient time and resources to improve their knowledge. Multiple studies about nursing identified the observations of the continuous need for skills and knowledge improvement.
Continuing education policy establishment is in the interest of such stakeholders as practitioners, healthcare and administrative organizations, policymakers, and academic institutions. The latter will need to update the curriculum of the courses and develop programs that allow the students to complete more practicum hours along with the theoretical learning (Crisp & Iro, 2018). Administrative organizations, such as AHCAP and AACN, also are interested because of their decision-making power for implementing new regulations at educational and healthcare facilities. Furthermore, administrative institutions and policymakers are the stakeholders to influence states’ boards of nursing to take the rules to action. Lastly, practitioners have the most interest because their academic and practice will significantly change if the policy issue is resolved. Consequently, nursing students and professionals must advocate for the universal regulations for continuing education through participating in local unions and notifying their workplace executives about the issue’s urgency (Thomas et al., 2020). A practitioner also can develop an evidence-based proposal about the severe outcomes for patients and the facility of missing out on qualification improvement and present it to their workplace’s quality improvement team.
There is no official nursing position statement on the issue of difficulties to receive continuing education. The standards and financial capabilities of states vary, and it is complicated to develop a universal regulation that would be supported by all practitioners nationwide. However, continuing education’s purposes, accreditations, commercial and sponsorship policies have already been developed by American Public Health Association (APHA). These statements exist to motivate practitioners and organizations to advocate for continuous professional development and maintain a high level of competency (American Public Health Association, n. d.). Policymakers need to consider the APHA’s practices in their regulations’ to create appropriate and applicable regulations for most stakeholders.
Policy Solutions
Policy solutions for addressing the challenges in receiving continuing education for nursing practitioners can be reviewed through the degree of change they make. Indeed, no specific interventions in curriculums’ structure in the academic setting and slight updates in licensing requirements of all states will result in no practical improvement (Melnyk et al., 2018). Nursing professionals will still face financial difficulties in receiving continuing education, the lack of time to complete it due to the busy working schedule, and the inability to move between states to build their careers. Partial change can be reached through the policy options that would allow the initiatives to be presented by healthcare organizations, academic institutions, and professional boards. For instance, each area’s principal public health issue can be viewed from the nursing continuing education perspective, and policy-based solutions can be offered. In contrast to the open communication strategy, a mandatory policy option, such as generalization of a curriculum and equal practicum hours completion nationwide, can result in the radical change (Thomas et al., 2020). Furthermore, financial regulations implementation can help organizations improve their continuing education conditions rapidly.
Theoretical Underpinnings of Solutions
The solution to avoid specific implementations in the policies about continuing education and local regulations is theoretically based on the need to adjust them will inevitably occur in the future. The rapid technological development, the growing gap in practitioners’ skillfulness, and the unexpected challenges such as the COVID-19 pandemic would force policymakers to update regulations. The open communication option can be supported by the research that proved the effectiveness of small local solutions for states and slight yet effective changes achieved by the nursing boards (Crisp & Iro, 2018). Mandatory regulations’ implementation’s theoretical underpinning was the experience of the ACA establishment when the entire healthcare sector was forced to adjust and improve. Each option requires the involved organizations and practitioners to advocate for the public health services quality increase through the providers’ continuing education (Coleman et al., 2018). Furthermore, leaders must combine the development of the evidence-based statements with proper encouragement tactics to maintain their teams, boards, or organizations’ interest in achieving sustainable results.
Inter-Professional Collaboration for Solutions
Inter-professional collaboration is crucial for all solutions to be implemented as the simultaneous work of multiple participants is required to achieve the policy-based change. The local updates in license obtaining systems must be raised by the nursing board, and educational organizations must report if they have sufficient time and workforce to adjust curriculums (Thies & Serratt, 2018). Furthermore, healthcare facilities should analyze if the new regulations threaten the availability of practitioners and the quality of their activities. Open communication policy solution equals the inter-professional collaboration as the opportunity for each stakeholder to reveal their position and work together with others occurs (Melnyk et al., 2018). If the mandatory policy updates are implemented, combined activities of multiple professions would be necessary to execute the projects and evaluate their efficiency. The policy issue of continuing education for nursing practitioners requires inter-professional collaboration regardless of the solutions.
Pros and Cons of Suggested Changes
Open communication and discussion before establishing universal policies is the most beneficial approach as it enables all stakeholders to analyze how continuing education updates would update their fields. Furthermore, discussion of current practices among different states or organizations is profound for experience exchange and further improvement (Melnyk et al., 2018). The major disadvantage is that universal interventions are time and finance-consuming, and the unpredicted circumstances such as the pandemic can disrupt the process (Crisp & Iro, 2018). Another con of open communication policy solution is that universal agreement has low feasibility as several stakeholders would not benefit from regulations.
The change in local licensing requirements and continuing education has the benefit that it would address specific needs; thus, services improvement and better patient outcomes would be visible shortly after the policy implementation. The disadvantage of narrow interventions is the financial aspect as multiple states have neither public nor private support for practitioners’ learning courses development (Thies & Serratt, 2018). The benefit of mandatory policy update implementation is that all participants will be obliged to take action, and the novel integrations would quickly influence the healthcare services. The con of the approach is that the intervention can result in protests among practitioners and organizations forced to spend more time and resources on continuing education initiative applications.
Building Consensus
The plan for building consensus to resolve the lack of workable universal regulations for continuing education for nursing practitioners must clarify responsibilities, implement inter-professional agreements, develop actionable strategies, and include assessment approaches to measure efficiency. Consequently, the proposed agenda can be mapped as:
- Conducting research among the nursing boards and administrative organizations to identify the key issues of continuing education.
- Drafting the policy proposal, mentioning the stakeholders, and describing their responsibilities.
- Providing time and place for inter-professional agreements to be discussed and established for further execution (Coleman et al., 2018).
- Select the leaders for each segment of stakeholders, and identify their responsibilities.
- Implementing the action plan in agreement with the government and sponsors.
- Adjusting the evaluation strategies to local facilities and developing the feedback options for every participant.
Conclusion
The policy issue is the lack of a systematized approach to improving studying programs for practitioners, insufficient funds for their clinics, and the inability of local health care administrators to establish workable regulations for continuing education. Proposals to achieve solutions to the problem are a fundamental part of making progress in the healthcare industry, and the regulations must comply with the current challenges and forecasts. The demand for highly-skilled professionals in the changing health care industry has been being researched since the ACA passage in 2010, and today it is even more urgent due to the COVID-19 outbreak. The policy updates are the most workable strategy to assist practitioners in continuing education, and implementation of universal regulations can help the organizations to build solid practices for supporting their workforce skills’ improvement.
References
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