NURSES’ INVOLVEMENT IN POLICY MAKING AND IMPLEMENTATION PROCESS REGARDING POST CORONARY ARTERY BYPASS GRAFTING PATIENTS. A QUALITATIVE CONTENT ANALYSIS

Abstract

Introduction: The anticipated mortality from coronary artery diseases (CAD) will be 25 million by 2025 throughout the Globe. Coronary Artery Bypass Grafting (CABG) is the most performed procedure in this regard worldwide. The process of preparing a plan and intention to achieve the goals through concerned individuals is called policy making. Policymaking and nurses are closely related to each other which can benefit the health system in terms of patient care. Nurses’ performance is related to their involvement in policymaking and implementation processes at the higher level which makes them competent enough to participate in issues related to patients by addressing the concerned agendas. However, nurses are mostly ignored in policymaking and implementation processes by the leadership and administration. Certain factors such as poor infrastructure, lack of proper goal setting, complex system, the inability of the organization to monitor and evaluate nurses’ abilities for participation in policy-making, negative image of nurses, misunderstanding in the society about nurses, lack of acceptance and empowerment in policy-making, autocratic administration and resistance to move forward are the challenges in this regard.

Material & Methods: The study was conducted at tertiary care government and private hospitals in Peshawar, Pakistan, from November 2020 to May 2021. A phenomenological research design was used, and data was collected through semi-structured interviews with the help of an interview guide and probing questions to understand nurses’ experiences and involvement in policy making and implementation process among Coronary Artery Bypass Grafting (CABG) patients. Dominant constituents, clusters, subthemes, and themes were framed through Moustakas modified van Kaam analysis model.

Results: A total of 16 nurses; 07 male and 09 female participated in the study. Three main themes were generated: no involvement in policy-making, promoting policymaking among nurses, and passion for caring. Most of the participants viewed that nurses are not involved in policymaking about post-CABG patents. Furthermore, nurses have the highest contribution to patient care but still are not accepted by patients, administrators, health workers, and society.

Conclusion: Nurses are involved in providing care to patients but in policy development, nurses are not involved. They must be involved in providing care.