Policies are also important becuase they inform patients and families about their rights and responsibilities with respect to the services they recieve. In many urban and academic healthcare settings, ethics committees have a role in policy development, review and evaluation. Only about a third of the ethics committees had a role in policy actitivities. Given this finding it can be difficult for rural hospitals to meet the challenges of policy development. To further complicate the issue, policies imply two competing perspectives.
Policy involves both process and product.
The education materials on policy should therefore be designed to bridge these two perspectives. There are no hardfast rules or guidelines for how to begin the process of policy development and subsequent reviews and evaluation. In addition, some of the hospital personnel who may become involved in policy development may have had very little formal training in this area. Generally resources are very limited in rural hospitals which was evidenced in our nurses survey. The vast majority of nurses reported few opportunities for education activities.