Institute of Medicine

Institute of Medicine (IOM) in partnership with Robert Wood Johnson Foundation (RWJF) conducted 2 years of research (2008-2010) to assess and transform the nursing profession in an effort to improve the overall healthcare in United States. The new model health care system is focused on health maintenance, disease prevention, and providing quality care to improve health care outcomes. This study identified reforming nursing profession is vital to improve the overall quality of healthcare.

The major areas of recommended changes are nursing education, practice and leadership. Recommended modifications in these areas of nursing will serve as an integral part of attaining the goals set forth in the Affordable Care Act (2010). In order to transform nursing education IOM recommended “Nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression. It clearly shows that the IOM recommends nurses to pursue continuing education to be able to cope up with the major changes in the healthcare. One of the main recommendations of IOM was to increase the percentage or BSNs to 80% by 2020 and encourage more nurses to pursue continue their way to APRNs and DNP to recover the shortage of nurses in these areas.

Even though there is no clear data available to prove that nurses holds BSN can perform better than a nurse with ADN, it is clear that the bolster knowledge the BSN nurses receives during their 4 year education in the area of community and public health issues, leadership, health policy and health care financing, leadership, quality improvement, and systems thinking will allow them to perform better in the changes that the reformed health care system brings in.

Increasing number of hospitals, especially Magnet hospitals already prefer nurses with BSN for employment. I consider continuing my education by staring my BSN program is a major path that enables me to survive the inevitable changes in the healthcare. After reviewing data from different resources the IOM survey made the conclusion that nurses, especially APRNs are not practicing to the full extent of their skills and knowledge that they acquire during their curriculum. So they recommended “Nurses should practice to the full extent of their education and training”.

The survey identified one of the major cause of nurses not able to practice to the fullest is because of the restrictions in laws and regulations, cultural and historical barriers. The committee determined that these restrictions will have to be lifted in order for nurses to undertake the responsibilities they can and should be taking during this time of great need. The lack of enough primary care physicians is one of the major problems that cause preventive and continuous care not accessible and affordable to the people in need.

It can be solved by utilizing the skills of APRN like NPs who could safely and effectively provide more than 90 percent of pediatric primary care services and 75 percent of general primary care services (IOM, 2011). In the hospital settings RNs needs to be trained to provide patient centered individualized care focused on prevention of complications and hospital acquired infections and re admissions. As a primary nurse in the inpatient care I should be receptive to the new health care goals that are preventive and cost effective and shifting to more community oriented care.

I should utilize knowledge and resources to co-ordinate seamless care. The IOM report suggested that in addition to changes in nursing education and practice it is important to focus on nurse’s leadership role in order to achieve the goals of the reformed health care systems. Nurses being the only health care professional, who spends most of their work hours in direct care of the patients can play a vital role in identifying chances of improvement, conduct and contribute to researches and implement and evaluate outcomes.

Traditionally nurses have not been considered as leaders by public and nurses themselves had not been utilized their role as leaders. The committee developed the message that nurses involvement in the health care policy decision making and implementation is an integral part of the success of the health care reformation for positive improvement. In order to achieve this “nurses should be full partners, with physicians and other health care professionals, in redesigning health care in the United States”.

Nurse’s involvement in policy making will give better understanding and control over the policies and encourage mutual respect collaboration with the other team members. There is documented data that shows this leadership from nursing profession will create positive work environment which leads to improved staff satisfaction and less staff turnover, better patient outcome, fewer medication errors, reduced length of hospital stay and cost saving. Nurse’s role as a leader is still evolving; a recent development in the role of nurse as clinical care leader (CNL) is a good indication of expansion of nurse role towards leadership.

The CNL assumes responsibility for healthcare outcomes by designing, implementing and evaluating patient plans of care. Nursing profession has a lot to offer to the transformation of the healthcare in United States. It is our responsibility as nurses to utilize the opportunity put forward to magnify the glory of our profession. The IOM recommendations helps us to understand that continuing our education, transforming the way of practice and identifying ourselves as a leaders are necessary to ensure that nurses are well- positioned to lead change and advance health of Americans and be a model for the rest of the world.

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