How nurses assure policy change for advanced practice registered nurses

How should nurses assure policy change for advanced practice registered nurses?” What role does the Affordable Care Act (ACA) play in addressing workforce shortages in rural communities?

 

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Nurses can play an important role in assuring policy change for advanced practice registered nurses (APRNs) by advocating at both the state and federal level. Lobbying legislators to create or amend laws that recognize the unique skills and expertise of APRNs is one way nurses can help ensure that they receive appropriate recognition and compensation for the services they provide (American Association of Colleges of Nursing, 2016). Additionally, engaging with other stakeholders such as employers, professional organizations and insurers is a key component in getting new policies established or existing ones modified (American Association of Colleges of Nursing, 2016).

Nurses can also make use of strategic communication strategies to advocate for improved access to APRN services within their community. This could involve speaking directly with decision makers about how policy changes could benefit members of their organization as well as creating public awareness campaigns using social media or other forms of outreach. In addition, participating in meetings with local, state or national policymakers provides an opportunity to discuss potential solutions on a larger scale while building relationships between healthcare providers and government representatives (American Association Of Colleges Of Nursing, 2016).

Another effective way nurses can work towards reforming APRN policy is by helping them gain more recognition within other healthcare professions. For example, Nurses may be able to serve on boards or committees where APRNs are discussed so that their opinions can be heard when decisions about access are being made (American Association Of Colleges Of Nursing ,2016). Inviting lawmakers on site visits to facilities where APRNs are providing exceptional care would also give them direct insight into how these professionals contribute positively to patient outcomes.

Although these measures won’t guarantee results overnight; if done consistently over time they will show elected officials just how valuable these practitioners are which should lead to meaningful policy reforms concerning Advanced Practice Registered Nurses.

The basic aim of the personalized medicine is applying right therapy to the right population of people by defining disease at the moecular level. So, identifying differences among the individuals support the new treatment methods and pharmaceutical companies to develop new cancer drugs. Patients who have similar clinical outcome and histological tumor type can give different response to the same drug(17). Prediction of who will be a nonresponders reduces the harmfull effect of drug on nonresponders like a potential toxic effect of drug and cost effect. Also when drug companies develop new drug, they focus on the patient population that benefit from drug to increase positive responds(17).

U.S. Food and Drug Administration bringed development about targeted therapy. For example, to treat chronic myeloid leukemia and gastrointestinal stromal tumor(18) ,imatinib mesylate is used and to treat breast cancer(19), trastuzumab (Herceptin) is used. Molecular characteristics of these cancer types that are abnormal protein tyrosine kinase activity in chronic myeloid leukemia and gastrointestinal stromal tumor and HER-2 receptor in breastcancer is used as a predictive biomarker. By using these markers only individuals which have these molecular alteration is selected and it means they are favorable for the treatment. Using this way some cancer types’ survival rate is shifted from 0 to 70%(17).

This application is used in non-small cell lung cancer treatment with using of mutations screeing. In this cancer type mutation occurs in kinase domain of EGFR. Gefitinib (Iressa) and erlotinib are tyrosine kinase inhibitors drug are used to treat and patients give a higher response to the treatment(20). Also if patient that is never smoked Asian females have adenocarcinomas, these drugs efficient on them(21). On the other hand, if the mutatuions occur at downstream effector KRAS, patient is resistant to to erlotinib(22). Also mutations that is at KRAS have a resistance to cetuximab (Erbitux) and panitumumab (Vectibix) drugs in colon cancer patients. If the KRAS is wild type, these these drugs is effective on the patients(23). These responses that are specific and different are based on molecular profile. Some molecular test are done before the using of cetuximab or panitu

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