Despite measurable progress in the three years since the release of the Institute of Medicines landmark report on the future of nursing, more work remains to fully realize the potential of qualified nurses to improve health and provide care to people who need it.
That assessment is part of a commentary by Harvey V. Fineberg, MD, PhD, president of the IOM, and Risa Lavizzo-Mourey, MD, MBA, president and CEO of the Robert Wood Johnson Foundation, on the aftermath of the report.
The Future of Nursing: Leading Change, Advancing Health was released Oct. 5, 2010, by the IOM with the support of RWJF. It provided a blueprint for transforming the nursing profession to respond effectively to rapidly changing healthcare settings and an evolving healthcare system, according to a report brief.
The key recommendations: allow nurses to practice to the full scope of their education and training, provide opportunities for nurses to serve as healthcare leaders and increase the proportion of nurses with a BSN to 80% by 2020. Following the report, RWJF and AARP formed the Campaign for Action to implement the reports recommendations at the state level.
Regarding scope of practice for advanced practice registered nurses, Fineberg and Lavizzo-Mourey wrote that 43 state action coalitions have prioritized initiatives to remove scope-of-practice regulations that prevent APRNs from delivering care to the full extent of their education and training. Iowa, Kentucky, Maryland , Nevada, North Dakota, Oregon and Rhode Island have removed barriers to APRN practice and care, and 15 states introduced bills this year to remove physician supervision requirements that can hinder APRN care.
Regarding education and training, the proportion of employed nurses with a BSN or higher degree was 49% in 2010 and 50% in 2011. Progress is likely to accelerate in the years to come, Fineberg and Lavizzo-Mourey wrote, because between 2011 and 2012 along there was a 22.2% increase in enrollment in RN-to-BSN programs and a 3.5% increase in enrollment in entry-level BSN programs. The authors also noted a recent increase in the number of students enrolled in nursing doctorate programs. Of the 51 action coalitions, 48 have worked to enable seamless academic progression in nursing.
The authors noted that the influence of the campaign has paid off with a $200 million Medicare initiative to support the training of APRNs at hospital systems in Arizona, Illinois, North Carolina, Pennsylvania and Texas.
Regarding nurse leadership, Fineberg and Lavizzo-Mourey wrote, the Campaign for Action has tapped established and emerging nurse leaders across the nation and is working to provide them with opportunities for networking, skills development and mentoring. A key strategy is to advocate for more nurses to serve on hospital boards.
Full commentary: http://bit.ly/176XyZs
Campaign for Action: http://www.rwjf.org/en/topics/rwjf-topic-areas/nursing/action-coalitions.html
Future of Nursing report: www.iom.edu/Reports/2010/The-Future-of-Nursing-Leading-Change-Advancing-Health.aspx
Graduate Nurse Education Demonstration: http://innovation.cms.gov/initiatives/gne/.