Assessing the policy environment

This article proposes a basic framework for assessing the policy environment. Environment is a key concept in nursing's much-discussed "metaparadigm," but the policy environment is rarely considered. Too often, bedside nurses do not recognize the policy dimensions of clinical practice issues. Yet nursing assessment involves identifying and appraising aspects of patients' situations that are salient to their responses to actual or potential health problems. Policy may be such a salient factor, as it shapes the physical aspects of patients' surroundings; the relationships possible between practitioners and patients; the institutions in which health care is offered; and, on a broader scale, the prospects for global survival. This article proposes a question-based framework for clinical practice nurses to use in assessing the policy environment.