Influencing Health Policy with Pain Management Nursing Research ANN M. SCHREIER, PHD, RN

Transcription

1 Influencing Health Policy with Pain Management Nursing Research ANN M. SCHREIER, PHD, RN Disclosures Dr. Schreier has no disclosures to report Objectives Describe current influences on health policy development regarding pain Appraise level of research needed to inform pain health policy Recommend future nursing research directions in pain management 1

2 Scope of Policy Institution level State level Federal level Frameworks for shaping health policy Hinshaw and Grady (2011) identified Data-Driven Policy Making (Weinick & Shin, 2003) Evidence Informed health policy (Green & Bennett, 2007) Moving from Issue to Policy (Shamian et al, 2002) Evidence-Informed Health Policy: Functions (Green & Bennett, 2007) Research prioritysetting Knowledge Generations & disseminations Evidence filtering & amplification Policy-making processes 2

3 Evidence-informed policy: Influences Ideology & values Ability to Use evidence Personal Interests Personal Experience & intuition Evidence-Informed Health Policy: Organizations Media Funding bodies Research institutions Think tanks Government Bodies Advocacy Organizations When is nursing research most likely to influence policy Addresses major public health issue Multiple audiences interested Addresses the economics Focus is on clients, families or communities 3

4 When research evidence most likely helpful There exists a disagreement about plan of action and research will assist policy makers to save face Research provides support for strongly held beliefs Least likely that research used Hidden agendas exist Strongly held values and beliefs by policy makers Examples current issues that highly influence policy and do not take into account research evidence Differentiation of chronic malignant vs. non-malignant pain Dose limits for opioid prescriptions 4

5 Reading the tea leaves Window of opportunity Concern of opioid substance abuse epidemic Move the public discourse from pain management=opioids and opioids are bad May be a time for funding of research for alternative therapies, multimodal therapy or interdisciplinary demonstration projects Gap between data generators and data users Researchers Policy Makers Types of information sought by legislators Demographics, prevalence Disparity, severity Cost Data Addresses health and safety (may not belong here) 5

6 Strategic planning by organization Seek to set a research agenda for generation of knowledge needed to influence positive pain policy Goal for ASPMN is to focus on Examining what do we currently do to address some of crucial issues Position statements Knowledge development Influencing priority for funding of nursing research NINR (Symptom Science) NIH Interagency Pain Research Coordinating Committee Influencing policy makers Prescribing by pain intensity₁ Identified the need (gap): unsafe process Identify who will benefit: in-hospital patients across the continuum of age Level of evidence required Level of Evidence available Research questions (measurement of pain severity) Risks of opioid therapy Use of multi-modal 1. Pasero, Quinlan-Colwell, Rae, Broglio & Drew,

7 Communicating results Who needs to know Who are allies Questions to discuss What are main issues or foci for research? What gaps have we identified? What are barriers to generating knowledge to address these gaps? How can ASPMN use its influence to reduce barriers and generate knowledge? References Green, A., & Bennett, S. (Eds.). (2007) Sound choices enhancing capacity for evidenceinformed health policy. Geneva: Switzerland. Hinshaw, A. S. & Grady, P. A. (Eds.) (2011) Shaping health policy through nursing research. New York: Springer Publishing Co. Pasero, C., Quinlan-Cowell, A., Rae, D., Broglio, K. & Drew, D. ( ) American Society for Pain Management Nursing Position Statement: Prescribing and administering opioid doses based solely on pain intensity. Pain Management Nursing 17, doi: 1016/j.pmn Shaimian, J., Skelton-Green, J. & Villeneuve, M. (2002). Policy: The essential link in successful transformations. In M. McIntyre, E. Thomlinson & C. McDonald (Eds.), Realities of Canadian nursing professional practice, and power issues (2 nd ed., 6, ). Philadelphia: Lippincott Williams, & Wilkins. Weinick, R. M., & Shin, P. W. (2003). Developing data-driven capabilities to support policymaking. George Washington University: The Agency for Healthcare Research and Quality s (AHRQ). 7