Kingdon's multiple streams framework suggests that policy change is established when three streams, problems, politics, and policies, are properly integrated. Hence, to capture the dynamic nature of the agenda-setting process, these streams have to be identified during the agenda phase, decision phase, and the implementation phase ( Rawat & Morris, 2016). The identification of the problem is the first main thing in Kingdon's model (Baumgartner, 2016). The main problem with the policy related to the Nurse Practitioner Practice Act is the limitations of the extent of practice for the nursing staff, as stipulated by the Integrated Practice Agreement (IPA). The IPA sets several barriers in the full range of practice for nurses in Nebraska.
The second step is the political stream, which flows alongside the problem stream. In this stream, the NNP presented the problem though a wide range of documentation to three review bodies who assessed the validity of the issue. The reviews were representation of information from the HHS regarding existing concerns for the state in public health. The third stream is the policy stream (Rawat et al., 2016). The NNP proposal was supported at two levels. The agenda was then advocated for by the National Academy of Medicine and the Legislative Advocacy and Representation and Committee (LARC). In the windows section of the model, the policy would reduce limitation to the extensive limit of practice and facilitate increased accessibility to healthcare in the rural sections of Nebraska.
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APRNs can be aware of factors alluded to the problem stream through increased advocacy by acknowledged nursing groups. Increased education concerning APRN capabilities and the scope of practice across several states is also essential. The main challenge faced in the acute care nursing sector is the existence of personnel shortages and the instability of experienced staff. This results in a deterioration of the quality of care provided.
References
Baumgartner, F. R. (2016). John Kingdon and the evolutionary approach to public policy and agenda setting. In Handbook of public policy agenda setting . Edward Elgar Publishing.
Rawat, P., & Morris, J. C. (2016). Kingdon's “Streams” Model at Thirty: Still Relevant in the 21st Century?. Politics & Policy , 44 (4), 608-638.
