Healthcare delivery in the Unites States stimulates policy change at a rapid pace. The Patient Protection and Affordable Care Act of 2010 (ACA) is intended to expand access to care and ultimately improve the health of Americans. The Triple Aim, created by The Institute for Healthcare Improvement, delineates policy implications for improving population health, the healthcare experience, and per capita cost. The Quadruple Aim adds a fourth policy implication, for example, addressing the needs of the healthcare provider. Advanced practice registered nurses are key in carrying out the goals of the ACA and achieving the Triple and Quadruple Aims, via the formation of interprofessional teams. This article offers insight into these policy implications and identifies filters through which related nursing policy will be developed.

The number of women in United States prisons has increased, with the most rapid growth among women of childbearing age. Detrimental effects on maternal-infant attachment have been shown to exist when mothers and infants are separated at birth. The purpose of this exploratory study was to examine the impact of an out-of-prison nursery program, Baby and Mother Bonding Initiative (BAMBI), on maternal-infant attachment and nurturing competencies among women who gave birth while incarcerated. A sample of 41 participants was recruited through a “Closed” BAMBI Alumni Facebook page and nonprobability snowball sampling. Participants were surveyed, and responses were submitted online or via mail. Data were analyzed using descriptive statistics, correlation coefficients, multiple regression, and logistic regression. Results indicated that the number of children living in the mother's household was a significant predictor of positive maternal nurturance. Inversely, the high number of children in the household was the most significant predictor of increased risk for infants to have insecure attachment to mothers. As the number of women giving birth in prisons continues to trend upward, the need for more programs to promote best outcomes for both mother and infants is crucial.