Introduction: Nurses form the largest portion of health workers in the USA. They provide various health services to the population and work in different settings, including hospitals, nursing homes, learning institutions, etc. (Academics, 2022). Additionally, they work in medical research centers and occupy advocacy and leadership roles in the sector. The dynamic nature of nursing creates the need for easy adaptation to prevailing changes in the profession and the need for quality care. The paper will discuss the work of the Robert Wood Foundation Committee Initiative, outlining the four key messages that structure the IOM report recommendations. Also, it will discuss the role of state-based action coalitions and barriers to advancement.
Work of The Robert Wood Foundation Committee Initiative That Led to The IOM Report “Future of Nursing: Leading Change, Advancing Health.”
The future of nursing focuses on how stakeholders should modify nurses’ education, responsibilities, and roles to meet the increased demand for quality health care (Academics, 2022). Robert wood foundation committee developed recommendations that would aid in improving the quality of care and patients outcomes as proposed in the Affordable Care Act (ACA).
The first initiative was nurses should be involved with other health workers and undertake leadership roles at different levels to reform the healthcare system in the USA (Academics, 2022). Also, the committee advocated for the elimination of barriers that hinder nurses from fully applying knowledge and skills when providing care. It requires the legislature to make appropriate amendments to ensure that registered and well-advanced nurses can practice to their maximum potential.
Secondly, the committee recommends expanding opportunities for nurses to work collaboratively with other healthcare providers (Academics, 2022). To realize this, the IOM report advocates for partnership between health institutions, health education institutions, and public and private entities to develop nurses’ skills and experience through training and education. Also, it recommends raising the number of nurses with bachelor’s degrees by 80% and double doctorate owners by 2020, which will enhance research and delivery of quality care.
Key Messages that structure the IOM Report recommendations
Due to extensive change and tremendous complexity in health care, there was a need to eliminate outdated habits, regulations, policies, and attitudes. The committee formulated recommendations structured in four key messages.
The first key message was that “nurses should practice to the full extent of their training and education” (Institute of Medicine (US), 2022). The committee directed the state and federal to update and standardize the scope of practice regulations to maximize the utilization of APRNs’ skills and knowledge. Also, the committee urges the insurance companies and the state should allow patients to choose health providers to meet their needs, including APRNs. It advocates for removing barriers, i.e., financial, regulatory, and policy, to promote patients’ choice and access to care, fundamentally reforming the health care system. Moreover, nurses should be allowed to practice in the community or hospital as per their competencies, skills and education.
Secondly, “nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression” (Institute of Medicine (US), 2022). The committee found that an improved education system will ensure future and current nurses deliver quality, safe, and patient-centered care. The education system should develop tools for evaluation and improve standards and quality of care. Also, the education system should ensure nurses’ flexibility and ability to adapt to the changes in technology, demographic, and science that determine the delivery of care (Institute of Medicine (US), 2022). Furthermore, the committee agreed that nurses should move to higher levels academically. The practice will replenish the nursing pool, advancing the profession and providing knowledge on up-to-date quality care.
The third key message was that “nurses should be full partners, with physicians and other health professionals, in redesigning health care in the United States.” The committee recommends that nurses have a voice and roles in policy-making and implementation efforts. They should serve as a committee, board, and commission advisors and take leadership roles in education and administrative positions. Finally, the fourth key message was that “effective workforce planning and policy-making require better data collection and improved information infrastructure” (Institute of Medicine (US), 2022). The committee argued that for fundamental changes to occur, it requires a clear understanding of contributions from professionals, the composition of the health system workforce, and numbers, which can be from reliable and sufficient granular data.
The Role of State-Based Action Coalitions
The state-based action coalitions comprise local school systems, libraries, businesses, social justice groups, fire and emergencies services, foundations, etc. Nurses and other partners lead the coalition to drive changes at the local level. Its main objective is to transform health through nursing and build healthier societies (Campaign for action, 2022).
Initiatives that advance the nursing profession in California
California assembly passed and signed the bill known as AB 890 (Quinn, 2022). The bill authorizes Nurse practitioners to practice to the full extent of their training, education, knowledge, and experience without physician supervision (Quinn, 2022). The law will take effect in 2023, improving access to care and equity, which will help patients find clinicians at their own convenience, eliminate administrative pathway and unnecessary regulations to consumer access, and improve access to APRN care in areas experiencing physician shortages.
The other initiative is allowing Nurses to take various leadership positions in the health care system. Monica R. McLemore, a leader and a nurse, was selected to speak and address the issue of premature births at the white house-hosted conference (Campaign for action, 2022). She manages the case profoundly and appropriately. She acts as a role model for many nurses who have leadership ambitions and those who want to advance their careers in nursing.
Barriers to the advancement of the nursing profession in California
The following factors influence nurse practitioners’ practices in California. Lack of public awareness of practitioners’ scope of practice, insufficient support from physicians, reimbursement difficulties, and lack of full prescribing authority (A L Anderson, 2022). Nursing advocates have addressed these barriers by developing a reimbursement system that includes nurse practitioners regardless of their employment status. Also, they have developed informational programs that target increasing awareness of nurse practitioners’ roles. Interprofessional dialogue and respecting each other profession were found effective in eliminating the lack of support from physicians. Finally, restricted regulations are being altered with commitment from federal and state policymakers to support nurse practitioners’ scope of practice.
A L Anderson, L. (2022). Practice environment for nurse practitioners in California. Identifying barriers.. PubMed Central (PMC). Retrieved 15 May 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1303747/.
Academics, N. (2022). Nationalacademies.org. Retrieved 15 May 2022, from https://www.nationalacademies.org/our-work/robert-wood-johnson-foundation-initiative-on-the-future-of-nursing-at-the-institute-of-medicine.
Campaign for action. (2022). Action Coalitions – Future of Nursing: Campaign for Action. Campaign for Action. Retrieved 15 May 2022, from https://campaignforaction.org/our-network/state-action-coalitions/.
Institute of Medicine (US) Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing, a. (2022). Key Messages of the Report. Ncbi.nlm.nih.gov. Retrieved 15 May 2022, from https://www.ncbi.nlm.nih.gov/books/NBK209881/.
Quinn, W. (2022). New Law to Improve Californians Access to Care | Campaign for Action. Campaign for Action. Retrieved 15 May 2022, from https://campaignforaction.org/new-law-to-improve-californians-access-to-care/.
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