Issue Identification Presentation Peggie L. Powell, MSN APRN FNP-BC - - PowerPoint PPT Presentation

Issue Identification Presentation

Peggie L. Powell, MSN APRN FNP-BC NURS638 Health Policy, Leadership & Advocacy Virginia Commonwealth University

Learning Objectives

• 1. Identify a health policy issue that is linked to

student’s DNP scholarly project.

• 2. Demonstrate how the issue is relevant to quality

and safety in health care.

• 3. Examine the implications of health policy inaction.
• 4. Relate the identified health policy issue to a

theoretical model of policy design.

Health Policy Issue Introduction

• US drug overdose death rate has increased by 137%

since 2000 1

• 40 people die every day due to a prescription opioid
• verdose 2
• 80% of overdose deaths are unintentional 3
• HB 2167 Opioids and buprenorphine; Boards of

Dentistry and Medicine to adopt regulations for prescribing 4

Health Policy Issue’s Relevance to Quality & Safety

• DNP Project: RIOSORD tool to screen for risk of
• verdose and guide naloxone prescribing
• RIOSORD = validated tool, reliability in both the VHA

and IMS populations 5

• EBP approach to:

– improve patient outcomes – increase quality of care – encourage safe opioid use – promote safe opioid prescribing practices

Implication of Policy Inaction

• 14.7% increase in overdose

deaths in Virginia from 2013 - 2014 1

• In 1999, ~23 people died

from abuse of fentanyl, hydrocodone, methadone, and oxycodone 6

• 1,578% increase to 386

individuals by 2013 6

Theoretical Frame of Reference

Kingdon’s Streams Model

An issue gains traction on the policy agenda only when the three separate streams of activity couple with a choice opportunity. 7

Problem Stream:

Defining the problem

Window of Opportunity Policy Stream:

Developing a solution

Politics Stream:

Working the politics

Time

Integrating Health Policy Issue & Theory

Problem Stream Policy Stream Politics Stream

• America’s

prescription opioid epidemic

• Increasing rates of
• verdose deaths
• Increased media

coverage of the epidemic

• Drug related deaths

surpass MVA deaths in Va since 2013 5

• 2014 – Va BOP, naloxone protocol

established 8

• 2014 – Va DBHDS, REVIVE!

Program 6

• 2015 – VDH recommends

SAMHSA toolkit

• 2016 – CDC Opioid Guideline
• 2016 – Va CVS, dispense naloxone

without rx

• March 2017 – Va BOM emergency

guidelines for opioid prescribing (acute and chronic pain) 9

• 2013 – Va Delegate John

O’Bannon, protection for use of naloxone 8

• 2015 – Va General Assembly,

expand access to naloxone

• 2016 – Va General Assembly,

BOM licensees to obtain 2 hours CME 9

• 2016 – Gov. Terry McAuliffe and

Health Commissioner Marissa Levine, opioid addiction a public health emergency in Va 6

• 2016 – US Surgeon General,

TurnTheTideRx campaign 10

Window of Opportunity

• RIOSORD tool – screen for risk of overdose, increase access to naloxone
• Publish DNP project results, influence on naloxone prescribing
• Increase knowledge on RIOSORD tool – presentations; draft letter to CDC

and/or Va BOM

Learning Objectives

• 1. Identify a health policy issue that is linked to my

DNP scholarly project. (Slide 3)

• 2. Demonstrate how the issue is relevant to quality

and safety in health care. (Slide 4)

• 3. Examine the implications of health policy inaction.

(Slide 5)

• 4. Relate the identified health policy issue to a

theoretical model of policy design. (Slides 6-7)

References

• 1. Rudd, R. A., Aleshire, N., Zibbell, J.E., & Gladden, R.M. (2016, January 1). Increases in drug and opioid overdose

deaths: United States, 2000-2014. Morbidity and Mortality Weekly Report, 64(50);1378-82. Retrieved from http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6450a3.htm

• 2. American Public Health Association. (2017). Prescription drug overdose. Retrieved from

https://www.apha.org/topics-and-issues/prescription-drug-overdose

• 3. Dowell, D., Haegerich, T. M., & Chou, R. (2016, March 18). CDC guideline for prescribing opioids for chronic

pain – United States, 2016. MMWR Recommendations and Reports; 65(1): 1-49. doi: http://dx.doi.org/10.15585/mmwr.rr6501e1

• 4. Opioids and buprenorphine; Boards of Dentistry and Medicine to adopt regulations for prescribing, H. B. 2167,

2017 Regular Session Va. Legis. (2017).

• 5. Zedler, B., Saunders, W., Joyce, A., Vick, C., & Murrelle, L. (2015). Validation of a screening risk index for overdose or

serious prescription opioid-induced respiratory depression. Poster session presented at the 2015 American Academy of Pain Medicine Annual Meeting, National Harbor, MD.

• 6. Virginia Department of Behavioral Health & Developmental Services. (2014). REVIVE! Opioid overdose and naloxone

education for Virginia. Retrieved from http://www.dbhds.virginia.gov/individuals-and-families/substance- abuse/revive

• 7. Multiple Streams. (n.d.). Retrieved September 22, 2017 from the Political Frames Wiki:

https://politicalframes.wikispaces.com/Multiple+Streams

• 8. Lowe, J. (2014, May 21). REVIVE! opioid overdose prevention for the Commonwealth of Virginia [PowerPoint slides].

Retrieved from http://www.vrha.org/webinars_31_24881083.pdf

• 9. Virginia Board of Medicine. (n.d.). Announcements. Retrieved September 23, 2017 from

https://www.dhp.virginia.gov/medicine/

• 10. U.S. Department of Health & Human Services. (n.d.). The Surgeon General’s call to end the opioid crisis. Retrieved

from http://turnthetiderx.org/

Questions