Review the IOM report, "The Future of Nursing: Leading Change, Advancing Health," and explore the "Campaign for Action: State Action Coalition" website. In a 1,000-1,250 word paper, discuss the influence the IOM report and state-based action coalitions have had on nursing practice, nursing education, and nursing workforce development, and how they continue to advance the goals for the nursing profession.

Include the following:

1. Describe the work of the Robert Wood Johnson Foundation Committee Initiative that led to the IOM report, "Future of Nursing: Leading Change, Advancing Health."
2. Outline the four "Key Messages" that structure the IOM Report recommendations. Explain how these have transformed or influenced nursing practice, nursing education and training, nursing leadership, and nursing workforce development. Provide examples.
3. Discuss the role of state-based action coalitions. Explain how these coalitions help advance the goals specified in the IOM report, "Future of Nursing: Leading Change, Advancing Health."
4. Research the initiatives on which your state's action coalition is working. Summarize two initiatives spearheaded by New Mexico state's action coalition. Discuss the ways these initiatives advance the nursing profession.
5. Describe barriers to advancement that currently exist in your state and explain how nursing advocates in your state overcome these barriers.

You are required to cite to a minimum of three sources within 5 years to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.  

 

Answer:

Background:

In 2008, RWJF approached the IOM to establish a 2-year Initiative on the Future of Nursing, with the primary mission of producing a report containing recommendations for an action-oriented blueprint for the future of nursing, including changes in public and institutional policies at the national, state, and local levels. To produce this report, a committee examined and produced recommendations related to the following issues, with the goal of identifying vital roles for nurses in designing and implementing a more effective and efficient health care system:

Reconceptualizing the role of nurses within the context of the entire workforce, the shortage, societal issues, and current and future technology;

Expanding nursing faculty, increasing the capacity of nursing schools, and redesigning nursing education to assure that it can produce an adequate number of well prepared nurses able to meet current and future health care demands;

Examining innovative solutions related to care delivery and health professional education by focusing on nursing and the delivery of nursing services; and

Attracting and retaining well prepared nurses in multiple care settings, including acute, ambulatory, primary care, long term care, community and public health.

Step-by-step explanation

The Future of Nursing: Leading Change, Advancing Health," IOM envisions a future where "primary care and prevention are central drivers of the health care system, interprofessional collaboration and coordination are the norm, and payment for health care services rewards value, not volume of services, and quality care is provided at a price that is affordable for both individuals and society." To achieve these goals, IOM recognized that many of the aspects of the health care system must be changed, including the nursing profession, which, with more than 3 million members, represents the largest segment of the health care workforce.

n order to expand the role of nurses, the report first recognizes the need to allow nurses to practice in accordance with their professional training. IOM also recognized the need for nurse education to "better prepare them to deliver patient-centered, equitable, safe, high-quality health care services; engage with physicians and other health care professionals to deliver efficient and effective care; and assume leadership roles in the redesign of the health care system." Consequently, IOM asserted that "an expanded workforce to serve the millions who will now have access to health insurance for the first time will require:

• Changes in nursing scopes of practice
• Advances in the education of nurses across all levels  
• Improvements in the practice of nursing across the continuum of care
• Transformation in the utilization of nurses across settings, and
• Leadership at all levels so nurses can be deployed effectively and appropriately as partners in the health care team.

Report Recommendations

As a result of its deliberations, the committee formulated four key messages that structure the discussion and recommendations presented in this report:

• Nurses should practice to the full extent of their education and training.
• Nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression.
• Nurses should be full partners, with physicians and other health professionals, in redesigning health care in the United States.
• Effective workforce planning and policy making require better data collection and an improved information infrastructure.

IOM arrived at these recommendations by acknowledging the unique role that nurses play in the health care system. Because nurses have regular and close proximity to patients and scientific understanding of care processes across the continuum of care, they have a unique ability to act as partners with other health professionals and to lead in the improvement and redesign of the health care system and its many practice environments, including hospitals, schools, homes, etc.

In addition, the recommendations reflect the ability of nurses to help bridge the gap between coverage and access, to coordinate increasingly complex care for a wide range of patients, and to enable the full economic value of their contributions across practice settings to be realized. This includes nurse's crucial role in preventing medication errors, reducing rates of infection, and even facilitating patients' transition from hospital to home.

Nursing practice covers a broad continuum from health promotion, to disease prevention, to coordination of care, to cure—when possible—and to palliative care when cure is not possible. However, IOM acknowledged that "many members of the profession require more education and preparation to adopt new roles quickly in response to rapidly changing health care settings and an evolving health care system."

The recommendations also recognize how restrictions on scope of practice, policy- and reimbursement-related limitations, and professional tensions have undermined the nursing profession's ability to provide and improve both general and advanced care. As a result, IOM asserts the need to transform the work environment, scope of practice, education, and numbers of America's nurses by creating a health care system that delivers the right care—quality care that is patient centered, accessible, evidence based, and sustainable—at the right time.

The role of continuing education (CE) will be crucial in realizing the IOM recommendations. Not only will CE for nurses need to cover many more areas of training and education, it will also need to focus on team-based approaches for collaborating with other physicians, which also means that CE for physicians will have to focus on interacting with nurses. Accordingly, CE must play a critical role in realizing the potential benefits of health care reform by improving the role nurses play in the health care system and improving patient outcomes. 

Ultimately, the IOM recommendations focus on the critical intersection between the health needs of diverse populations across the lifespan and the actions of the nursing workforce. Based on these recommendations, it is clear that America will need to educate and train nurses to handle many areas of medicine and to help create a patient-centered health care system if health care reform will be successful and improving care and reducing costs.

This is encouraging, but some system changes need to happen for nurses, including changes in compensation towards procedures and productivity, the shift work mentality often found with hospital nurses needs to change.  Nurses taking on more responsibility will mean greater accountability.

Reference:

https://www.cram.com/essay/The-Work-Of-Robert-Johnson-Foundation-Committee/PK3N8R9UR4E5

https://nursing.unc.edu/wp-content/uploads/sites/252/2013/12/Future-Nursing-Report-IOM.pdf