As congress debates over the many different points of the Affordable Healthcare Act, the one issue that is in the forefront is how will the health care system provide care for all these additional people. In order to provide quality care many believe the health care professionals roles will need to be expanded. Since nursing is the largest, and encompasses 3 million of the healthcare workforce, it will be imperative that the nursing roles expands to meet these needs(Sullivan, 2011).
Because nurses have a unique position in healthcare due to their scientific knowledge and proximity to patients, (Sullivan, 2011), the Institute of Medicine(2011) concluded that ” nursing brings to the future a steadfast commitment to patient care, improved safety and quality, and better outcomes” (Future of Nursing, p167). In October 2010, the Robert Wood Johnson Foundation (RWJF) and the Institute of Medicine (IOM) jointly released The Future of Nursing: Leading Change, Advancing Health. This report focuses on how nursing can help to meet the demands of an increased population of patients.
This report has four key points. “(1) ensure that nurses can practice to the full extent of their education and training, (2) improve nursing education, (3) provide opportunities for nurses to assume leadership positions and to serve as full partners in health care redesign and improvement efforts, and (4) improve data collection for workforce planning and policy making. ” (Future of Nursing, p29) The report outlines how the nurses role will need to transform into one of a primary caregiver, and what actions will need to be taken to fulfill this role. Effects Of IOM Report on Nursing Education
Nursing has the most diverse background in education that any other profession. Diploma graduates, Associates’ degrees in nursing and the baccalaureate of science in nursing are the three major pathways into entry-level nursing. Now there is an option for those who possess a bachelors degree in another field to get a BSN through an accelerated program(Future of Nursing, p165). The IOM (2011) report suggests that “ an all BSN workforce would provide a more uniform foundation”(Future of Nursing, p170). One of the goals of the IOM report is to have 80% of the nursing workforce will possess a bachelors by 2020.
In order to facilitate this there will have to be fundamental changes to nursing education. Most studies show that nursing programs focus mainly on the acute care setting, leaving out critical knowledge needed to provide care to the community. A wider knowledge base will help to ensure proper care for the upcoming changes in American healthcare. Providing seamless transition into a baccalaureate program from nursing, and more funding for programs will be essential to this transition. (ISNA, p10). The IOM report focuses largely on expanding the role of the nurse into that of an APRN (advanced practice registered nurse).
The amount of patients under the new Affordable Healthcare Act is going to increase significantly. The IOM(2011) report states “ As the health care system grows in complexity, expectations are that APRN’s will have competence in expanding areas such as technology, genetics, quality improvement, and geriatrics” (IOM, p197). The demand for NP’s, nursing research, faculty, and other APRN’s has and will continue to climb. The future of health care is moving towards management of chronic illnesses, health and prevention. This will require more research and public education.
Functions that are fundamental to nurses already. Increased knowledge will facilitate a better outcome for patients. Effects of IOM Report on Nursing Practice The goal of the report to meet the impending demands of practitioners from an increased number of patients is using a team-centered approach where primary caregivers provide care through a spectrum of healthcare settings. By utilizing APRN’s you could effectively increase the quality of care while decreasing costs. By providing care through a proactive standpoint rather than reactive, the number of inpatient admissions would decrease.
Using a team centered approach to manage a patients healthcare would ensure seamless care for the patient through a variety of settings. The future of healthcare is trending towards prevention and total care of the patient. Nurses need to advance their education to meet the goals of educating and providing care outside the acute care setting. The report notes that Kaiser is using a new model known as Guided Care. This model allows the nurse to work with 3-4 physicians to help manage patients with chronic care issues.
These RN’s receive specialized training in all aspects of care that range from insurance to transitional care. (IOM, 2010) Working for a small community hospital, it would be a great asset to help develop this type of model. Physicians are inundated with patients, and it is impossible to manage care correctly. By applying these principles to all hospitals, we could effectively work as a team to decrease hospital admissions. Working in the ER, spending more time teaching patients with chronic illnesses and giving information for community services available would help this goal. Effects of IOM Report in Nursing Leadership
IOM (2010) Key message: Nurses should be full partners, with physicians and other health care professionals, in redesigning healthcare in the United States(IOM, p Nurses are not commonly viewed as leaders in the healthcare community. (IOM, 2010). Few nurses enter the field with intentions of moving into a leadership position. Along with education and primary care, nurses must adapt to a new role where they are not just a piece of the system, but play integral part.
IOM (2010) states, “ nurses must see policy as something they can shape rather than something that happens to them. Leadership styles that incorporate everyone working and where nurses are actively involved in decision-making will give overall improvement patient outcomes, improvement in the organization, and enhanced nursing(“ Visioning the Future of Nursing: Analysis of the IOM/RWJ Foundation Report,” 2011, p10). Education and support need to be given to help nurses enhance these roles. The Affordable Healthcare Act is going to change they way care is provided, from the physicians to the bedside nurses, to hospital administrators.
Working together to formulate a plan of action is the only the system will survive. Nurses play a key role in these changes. Nurses have the highest capacity to change their roles, and must embrace the change to ensure exceptional care for all. 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”(ISNA, 2011).
