The Robert Wood Johnson Foundation Committee Initiative
Describe the work of the Robert Wood Johnson Foundation Committee Initiative that led to the IOM report, “Future of Nursing: Leading Change, Advancing Health.”
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.
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.”
Research the initiatives on which your state’s action coalition is working. Summarize two initiatives spearheaded by your state’s action coalition. Discuss the ways these initiatives advance the nursing profession.
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 to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.
The Advancements in the Profession and Practice of Nursing
This paper discusses the impacts of the Institute of Medicine (IOM) Report titled ‘The Future of Nursing: Leading Change, Advancing Health’ on the nursing practice and profession. The scope of the discussion includes the influence of the IOM report on nursing education and training, practice, leadership, and workforce development. Besides, the role played by Campaign for Action: State Coalitions in advancing the goals specified in the IOM Report is also discussed. Implementation of the goals specified in the IOM report have helped to revolutionize nursing profession, practice and nursing education for the better.
In 2008, the Robert-Wood Johnson Foundation Committee Initiative influenced the IOM to develop a two-year initiative with focus on future of the nursing practice/profession. The primary objective was to generate a report that could give action-oriented recommendations on transformations in public and institutional policies at the local level, the state level, and the national level. The IOM report developed vision for ta transformed healthcare system. In the IOM vision, prevention and primary care should be central drivers of the healthcare system, payment for healthcare services should be based on value, interprofessional coordination and collaboration should be the norm, and quality care should be affordable to both the society and individuals (Sullivan, 2018).
The IOM report have four key messages, which structure the recommendations and discussion on transformation of nursing. The first key message states that nurses need to practice to the full scope of their training and education. The second key message states that nurses should attain higher levels of training and education via an enhanced system of education, which promotes continuous academic training advancement. The third key message is that nurses have to practice as full-partners with physicians and other health professionals, in the restructuring of healthcare in the U.S. The fourth key message states that effective policy-making and workforce planning require better data collection strategies as well as an improved information infrastructure (Sullivan, 2018).
The four key messages (outlined above) from the report recommendations have influenced or transformed nursing education and training, practice, leadership, and development of the workforce. With focus on nursing practice, the key messages from the IOM report have led to reconceptualization of nurses’ roles within the context of nurse shortages, whole labor force, future and current technology, and issues in the society (Palatnik, 2016). For example, one of the expanded roles of Registered Nurses in Pioneer-Accountable Care Organizations include delegating tasks to medical assistants and licensed practical nurses (Thomas, Seifert, & Joyner, 2016). Nursing practice changes also include renewed efforts to better entice and retain well-prepared nurses in various settings such as long-term care, primary care, ambulatory services, acute care, and public and community health (Sullivan, 2018). Further education and training of nurses has had a great impact in nursing practice including implementation of evidence-based practice, collaboration, improved patient outcomes and use of systems thinking (Palatnik, 2016).
Changes that have been observed in nursing education and training include expansion of the faculty of nursing, redesign of the education programs for nurses, and improved capacity of nursing schools to guarantee that they produce adequate number of nurses who are well-prepared to meet future and current healthcare demands. (Sullivan, 2018). The IOM report recommends that the number of baccalaureate-prepared nurses should have grown to 80 percent by 2020. However, nursing schools continue to turn-down qualified nursing applicants due to limited classroom space, lack of faculty, and limited clinical placement areas. Nurses cite competing priorities, financial concerns, and supposed lack of value in higher degree as some of the reasons for not pursuing a Bachelor’s degree in nursing (Palatnik, 2016).
Nurse leadership has been improved owing to advancement in nursing education and training. Nurses are nowadays leaders in advocacy for policy changes (Palatnik, 2016). On the other hand, Registered Nurses (RNs) have emerged to lead innovation in the healthcare industry. As innovators RNs act as change agents to drive policy and processed as well as leverage technology so as to better and more affordable healthcare for the community and individuals (Thomas et al., 2016). RNs do lead development of innovative practices and ideas to advanced health information technology and improve the quality of care (Thomas, Seifert, & Joyner, 2016). In 2015, the American Nurses Associated expanded the scope of practice and standards by calling on to the RNs to act as leaders within the nursing profession and by working to encourage innovation and to influence policies (Thomas et al., 2016). For example, nurses have developed protocols that have resulted in reduction of catheter-associated infections (Thomas et al., 2016).
There are some notable changes that have been observed in nursing workforce development. For example, the number of baccalaureate-prepared nurses have increased from 49 percent of the workforce in the year 2010 to 51 percent of the workforce in 2014 (Palatnik, 2016). The nursing workforce has achieved increased level of diversity in terms of education, training, ethnicity, race, and gender, a milestone that have improved delivery of healthcare services (Kovner et al., 2017).
State-based Action Coalitions play a significant role in advancing nursing practice and the nursing profession and by advancing realization of the goals specified in the IOM Report. State Action Coalitions are led by nursing professionals and business partners who drive transformations locally by working to change healthcare through building of better healthier communities and nursing (Campaign for Action, 2021). In Texas, the State Action Coalition promotes the idea that all residents of Texas merit better care, health, and lower health costs; and these can be achieved through nursing since nurses makes up the largest group of healthcare providers in the State (Campaign for Action, 2021).
One of the initiatives by Texas Action Coalition is develop of new insurance exchanges in which nurses will take leadership roles. Nurses are taking a central role in monitoring as well as identifying opportunities to educate other nurses and healthcare professionals about available information concerning the new insurance marketplace (Campaign for Action, 2021). The other initiative is that Texas has eased restriction on nurse practitioners. Advanced Practice RNs (APRNs) in Texas are no more required to hold face-to-face meetings with physicians. Communication can now be held through videoconference technology when the need arises (Campaign for Action, 2019). However, there remains some practice barriers in Texas for the APRNs. For example, APRNs in Texas are still required to hold prescriptive authority agreement; thus, they cannot practice to the full scope of their education and training (Campaign for Action, 2019). Nurse advocates in Texas should continue to push for policy change until nurses are allowed to practice to the full degree of their education and training.
In conclusion, recommendations of IOM report have helped to shape nursing training and education practice, workforce development, and nurse leadership in a positive way. State Actions coalitions facilitate achievement of the goals in the IOM report by facilitating nurses to act as front runners and advocates to improve the practice and profession of nurses and to improve delivery of care to communities. In Texas, nurses should advocate for expansion of the roles of nurses to practice to the full scope of their education and training.
Campaign for Action. (2021). State Action Coalitions. https://campaignforaction.org/our-network/state-action-coalitions/
Campaign for Action. (May 20, 2019). Texas eases restriction on nurse practitioners. https://campaignforaction.org/texas-eases-restriction-on-nurse-practitioners/
Kovner, C. T., Djukic, M., Jun, J., Fletcher, J., Fatehi, F. K., & Brewer, C. S. (2017). Diversity and education of the nursing workforce 2006-2016. Nursing Outlook, 66(2), 160-167. https://doi.org/10.1016/j.outlook.2017.09.002
Palatnik, A. M. (2016). The future of nursing: Leading change, advancing health…how we are doing? Nursing Critical Care, 11(3), 4. https://journals.lww.com/nursingcriticalcare/fulltext/2016/05000/the_future_of_nursing__leading_change,_advancing.1.aspx
Sullivan, T. (May 5, 2018). Institute of Medicine Report – The Future of Nursing: Leading Change, Advancing Health. Policy & Medicine. https://www.policymed.com/2011/02/institute-of-medicine-report-the-future-of-nursing-leading-change-advancing-health.html
Thomas, T.W., Seifert, P.C., & Joyner, J.C. (September 30, 2016). Registered Nurses Leading Innovative Changes. OJIN: The Online Journal of Issues in Nursing, 21(3), Manuscript 3. https://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-21-2016/No3-Sept-2016/Registered-Nurses-Leading-Innovative-Changes.html