Stocking Epinephrine in Schools: Policy-Making Visit Presentation

Introduction

• There is need to improve health care delivery in schools.
• This can be achieved through various ways such as stocking of epinephrine in schools to be administered in the case of anaphylactic reactions among students or faculty.
• A bill seeking the stocking of epinephrine in schools was presented to the Mississippi legislature but it died in the committee.
• A policy making visit is to be scheduled to push for the implementation of this bill.

Stocking of epinephrine is schools is a priority issue as the cases of allergies among school going children are increasing. They have increased by about 18% from 1997- 2007. Asthma and allergies are one of the leading causes of absenteeism in schools. Equipping schools with the resources needed to manage an anaphylactic reaction will help reduce cases of complications.

Sample of auto injectable epinephrine

The epinephrine to be stocked in schools is auto injectable epinephrine that is not patient specific.

Description of the legislative visit

• An appointment is to be scheduled with the office of the legislator both in writing and verbally.
• On the day of the meeting brochures with the message to be delivered will be printed.
• The message will be delivered in a clear and concise manner and the brochures given to the people who attended the meeting.
• A follow up plan will be agreed upon.

The message will consist recommendations and the discussion of the opinion of the legislator on the issue.

The policy making process

• In order that a bill becomes policy, it goes through a policy making process that involves:
  • An issue is discussed in the public agenda.
  • A bill is introduced in the house.
  • The bill is then assigned to a committee.
  • The committee decides on an action.
  • The action of the committee is brought to the floor of the house for voting.

In the process the bill may not pass the committee, either because it was not prioritized and therefore not discussed or it was rejected by the committee, in this circumstance the bill is said to have died in the committee. The bill to allow stocking of epinephrine in schools did not pass the committee, so it is termed dead.

Purpose of the Policy making visit

• The bill requiring schools to stock epinephrine died in the education committee.
• It will be reviewed again in the next committee meeting.
• The policy making visit is to get a legislator to commit to take action on the matter in order to ensure that the bill becomes policy.
• The people making the visit will include a registered school nurse, a parent of a victim of lack of epinephrine in school and a parent of a child with asthma or allergy.

Before the visit the group will book an appointment with the legislator, and set up goals to be achieved during the visit. In addition the group will print out their message and give a copy to the legislator and other members in the office of the legislator.

Message to the legislator

• The visit aims at informing the legislator of the importance of the situation at hand.
• 10% of all school going children have allergies; 50% of the 10% have a high risk of developing anaphylactic reactions.
• Accidental ingestion of allergens that may result in an anaphylactic reaction most commonly occurs at school.
• It takes about 1-2 minutes for a mild reaction to become an anaphylactic reaction.
• States such as Illinois have passed policies requiring stocking of epinephrine in schools.
• The bill seeks to ensure that epinephrine is stocked in schools and is administered by a trained faculty or staff in the event of anaphylaxis.
• Epinephrine is the drug of choice for all episodes of anaphylactic reactions.
• It has no contraindications in the event of an emergency.
• The current laws allow students with asthma or any known allergy to carry epinephrine to school and to self administer in the event of an anaphylactic reaction.

There is a rapid increase in the number of school going children with allergies between 1997 and 2007 there was an increase of 18%.(Young, Munoz-Furlong, & Sicherer, 2009)).

If the bill passes every school will be required to have a faculty member trained on how to recognize symptoms of anaphylaxis and when to give the auto injectable epinephrine. The training will be done by a registered nurse or a physician.

Follow up

• After delivering the message, a follow up plan should be agreed upon with the legislator.
• A contact person both in the group and the legislator’s office should be appointed.
• A timeline should be set after which the group expect a response from the office.
• A date of the next meeting should be scheduled.

The follow up plan will ensure that the group conducting the legislative visits are informed of any progress that has taken place.

Expected outcome of the policy making visit

• The legislator should be able to talk to the chairperson of the education committee to prioritize the bill.
• The legislator should convince the members of the education committee on the importance of the bill at hand.
• The legislator should try to get the group conducting the policy making visit audience with the Education committee to discuss with them the importance of the bill

The expected outcome is the expected response of the legislator.

Insights gained during the plan for the visit

• The policy making process is not necessarily determined by the importance of the bill.
• Other factors that may affect the policy making process include: party politics; preference of voters; pressure from interest groups and personal preferences of the legislators.
• It is important that when conducting the policy making visit the group takes all these issues into consideration.
• To ensure the bill becomes policy, the nursing fraternity should speak in one voice to support the bill. The one most important factor that influences nurses. participation in policy making within the health sector is solidarity among nurses (Benton, 2012).
• Nurses should also inform the public about the benefits of supporting the bill.
• The group conducting the legislative visit should be aware of the key players in the Mississippi house so that they can use them to ensure implementation of the bill.
• Nurses in various parts of the world have used their advocacy skills to make a positive impact in the health of the people they serve.
• In Rwanda, the nurses their used advocacy to fight for regulation in the profession this ensured the standards of nursing are maintained (Benton,2012).
• Improving the standards of education of nursing in Ghana improved the quality of care delivered to the patient.
• Nurses through advocacy can effectively influence policy.

In order that the legislator grants us our needs we need to be open to their needs so that the relationship is mutually beneficial. By listening to what they have they will also listen to what we have.

Being aware of the key players in the Mississippi house will ensure that the right person is approached to ensure that the legislative visit is successful.

The nurses in Ghana identified what they wanted and started following the policies they had set even before the government passed it as law. They put it in line with the governments intention of improving quality care.

Importance to nursing

• According to the world health organization (2011), policy making is the slowest area of development in the nursing profession.
• Nurses are usually involved in implementation of policies in the health sector rather than the making of the policies.
• Nurses should participate in the policy making process in order that the policies passed are inline with the nursing perspective (WHO, 2011).
• The International Council of Nurses’ global mission of the 21st century is to lead society to better health.
• This can be achieved through various ways but the only way with the greatest impact is through health policy making.
• This proposed visit is going to define the nurses’ role as a policy maker in the state of Mississippi.
• Following this visit, the nurse in Mississippi will develop a cordial relationship with the legislator.
• The relationship developed can be used to ensure that nurses are always involved during the making of health related policies.
• Nurses make up the majority of the health profession with more than 3million workers (Institute of medicine, 2010).
• With the numbers they should be able to influence the policy making process both as voters and professionals.
• This policy making visit, if successful will ensure the school nurse in Mississippi can effectively administer epinephrine to victims of anaphylaxis.

The world health organization recognized how laid back nurses are to make policies. It also recognizes that nurses are the majority and are key in implementation of policies. They should also play a major role in the making of the policies.

Policies target a large population, if this bill becomes policy, it will affect the whole state of Mississippi. It will ensure that every sector is improved. When nurses limit themselves to working to improve health care, they have an impact but to a smaller extend than policies.

Influencing policies made starts during the electoral process, nurses should support leaders who will support improvement of the health policies. In the United States 1 out of every 100 voters is a nurse, they can influence policies as early as when choosing the leaders with the right manifesto.

Future opportunities

• This legislative visit also advances the role of the nurse in policy making.
• This visit if successful may be used as an example to other nurses when advocating for policies.
• In addition the mutually beneficial relationship between the nurses in Mississippi and the legislature may be used to further develop other health policies.

This describes the role the policy making visit scheduled to take place will improve the future of nursing. The same way in this legislative visit, other past visits are sited, this visit may also be a point of reference in future.

Conclusion

• Nurses should actively participate in the policy making process as they are greatly involved in the actualization of health policies.
• The bill requiring schools to stock epinephrine will help actualize the main mission of the nursing profession which is to maintain health.
• This will be achieved through prevention of complications of anaphylaxis.

References

• Benton, D., (2012) “Advocating Globally to Shape Policy and Strengthen Nursing’s Influence” OJIN: The Online Journal of Issues in Nursing Vol. 17, No. 1, Manuscript 5.
• Institute of Medicine of advancing academies (2012). The future of nursing: Leading change advancing Health. Web.
• International Council of Nurses. (2010). Vision for the future of nursing. Geneva, International Council of Nurses. Web.
• World Health Organization. (2011). Strategic directions for strengthening nursing and midwifery services 2011-2015. Geneva, World Health Organization. Web.
• Young, M.C., Munoz-Furlong, A., & Sicherer, S.H. (2009). Management of food allergies in school: A perspective for allergists. Journal of Allergy Clinical Immunology, 124(2), 175-183.