Nursing Practice in the Extent of Their Training and Education - Assignment Example

The Impact of the IOM report Introduction There was a need for a re-examination because the nursing practice iswide including; public and community health centers, battlefields, facilities for long-term care, retail health clinics, homes, schools, hospitals, among other settings. Nursing profession is also broad, ranging from the nurse scientists whose main responsibility is to evaluate and research the ways for promoting health and caring for the patients; to practical nurses who are licensed to provide patient care directly in the nursing homes. These factors included the levels of education of the nurses, the settings under which the nurses work and the roles of nurses across the board. The committee, after its deliberations, presented four main messages in the report. Key messages discussed in the report Nursing practice in the extent of their training and education The report presented the message that strongly imposed the need for ensuring that nurses practiced their training and education to the fullest. The report acknowledged the fact that most of the nurses are registered (RNS). Moreover, there are over a quarter million nurses who are advanced practice registered (APRNs). This group of nurses possesses doctoral or masters degree certificates. All the nurse midwives, nurse anesthetists, clinical nurse specialists and the nurse practitioners are licensed as APRNs. However, there is exists a disparity in terms of the scope of practice and regulations across varied states. For instance, a number of states allow the nurses to prescribe medication to the patients without necessarily having to get the consent from a physician. However, there are other states that do not allow this practice. The report goes a step to offer recommendations that affect different stakeholders. There are reforms that are recommended. These reforms provide for the promotion of best practices in the nursing profession. There is a recommendation that is targeting the Federal Trade Commission. This targets the conduct that is anticompetitive in the healthcare markets including; policies that set barriers for new entries into the market and restrictions based on practices of business among the providers of health care. Improved systems of education are emphasized in the report. The report notes that there should be a higher level for training and education for the nurses. The system of education is supposed to be seamless in a manner that is friendly to the progression of academic development to the nurses. The delivery of improved system of nursing education and patient care settings are emphasized in the report. The needs of the patients have been more complex in recent times, making it inevitable for the nurses to achieve competencies that are requisite in the delivery of high quality health care. Such competencies include collaboration and team work, evidence and research based practice, development of the systems, health policies and leadership. Nurses are called upon to master the various technologically related tools and go an extent of filling up the expanded roles. There is also need for the nurses to coordinate several teams that are involved in the provision of health related issues. Due to the increase in demands, in the health care, there is the need for the nurses to achieve very high training and education levels. The nurse education programs are supposed to provide for a transition into higher degrees. This development is supposed to be seamless and one that is effective in the transformation of nurses from LPNs to bachelors or degree associates (Institute of Medicine, 2010a). The redesigning of healthcare in the United States of America is seen as being necessary. The nurses are, therefore, supposed to be full partners, together with healthcare professionals and other physicians. Nurses are supposed to be well equipped with the skills that are needed in the development of the health care. This goes hand in hand with preparing the nurses with the adequate skills for dealing with the emerging issues in the health care sector. These skills are also essential in helping the nurses to advance in their career. Nurses are leaders and need to collaboratively work with other leaders from the health profession towards achieving the quality delivery of health care. Must the nurses to take full responsibility and work towards identifying the different problems and challenges in the health care with the aim of achieving quality health care delivery. Serving in the advisory boards is essential in helping the nurses to be part of decision making processes. In this method, the health systems and patient care will be improved across the board. Nurses need to undergo nursing education programs that incorporate leadership related competencies. Through this, the nurses will be prepared to embrace leadership roles. There have been complexities in the patient needs over time, calling for the nurses to achieve leadership attributes and trainings that are effective. Lastly, data collection is seen to be an integral aspect of effective policy making and planning. Having an improved information infrastructure in the nursing profession is necessary for the achievement of quality healthcare delivery. In order to fundamentally plan the various issues of deployment and educational changes in the nursing profession, must a comprehensive review of types and numbers of health professionals. Once the infrastructure of study and collection of data is established, there is the need to have the workforce defined in terms of demographics, region, skill mix, roles and general educational needs. The Affordable Care Act of 2010 mandated for the creation of the National Center for Workforce and the National Health Care Workforce. These two entities are responsible for offering support for study and collection of workforce data. Furthermore, they also look Into how to gauge the health care worker’s demands respectively. The supply of healthcare is supposed to be effective and efficient. These programs were initiated in order to achieve effective monitoring system of the healthcare workers supply across the different professions. The programs are also important in reviewing the techniques that are needed for development and the review of the data pertaining to the nursing profession. The report emphasizes the fact that effective data collection methods are useful in the establishment of a healthcare system that is effective (Institute of Medicine, 2010b). Recommendations for transforming nursing. Removing of the barriers in scope-of-practice There is the need for a thorough reformation of the scope of practice in the nursing profession. The regulations need to be changed and revised in line with the rules and regulations of the National Council of State Boards of Nursing. These reforms should be carried out in various health care related stakeholders. On the part of the Medicaid and Medicare services, there should be an amendment to bring clarity about to the nurse participation in different aspects. The advanced practice registered nurses are supposed to be allowed to be part of the professionals that can access clinical privileges, admit those privileges and be members on the various medical staff. The Personnel Management office also needs to effect certain changes. This office is supposed to insist on the inclusion of the practices of the advanced registered nurses with reference to the state laws. This should affect the insurers who wish to participate in the Federal Employees Health Benefits Program. Lastly, the Antitrust Division of the Department of Justice and the Federal Trade Commission also need to reform the proposed and existing regulations that affect the advanced practice registered nurses. This should focus on those who indulge in practices that are anticompetitive and that do not contribute to the public’s safety in the healthcare. Those states with regulations that are unduly restrictive should amend the laws in order to allow the advanced practice registered nurses to work towards the provision of effective care to different patients with varied needs. Expansion of opportunities for the nurses to diffuse and lead development efforts that is collaborative The nursing associations, nursing education programs, healthcare organizations and the public and private funders have a role to play in the expansion of opportunities for nurses. Through the provision of these opportunities, the nurses will be able to manage and lead efforts that are collaborative. This collaboration is supposed to be made between the nurses and physicians and other members in the healthcare provision team. This will facilitate the conduction of research, redesigning and improving the environments of practice. The collaboration is also vital for the development of the health systems. Through the provision of these opportunities, nurses will be enabled to diffuse practices that are successful. The Medicaid Innovation and Center for Medicare should work to support the evaluation and development of the payment models that use nurses. The care delivery models and the leadership capacities that involve nurses are supposed to be improved, with the aim of reducing cost and improving the results of the healthcare systems. The development of performance measures should be emphasized and expeditiously implemented so as to ensure high quality of healthcare provision. The public and private funders are supposed to collaborate and pool funds to support the advancement of research models. Moreover, innovative solutions that include technology advancement should be considered. This step will ensure that the nurses can effectively contribute to the development of healthcare and health. Implementing programs for nurse residency. Nurse residency should be supported by healthcare organizations, the federal government, accrediting bodies and nursing state boards. During the transition of nurses to new clinical practice areas, nurses need to be supported. In implementing and supporting the residency programs for nurses, there are several recommendations from the committee. It is the responsibility of the Community Health Accreditation Program in collaboration with the Joint Commission to support the nurses in completing their residency programs. This is after they have completed their advanced practice degree program and are now transforming into practice areas. The Secretary of Health and Human Services is supposed to redirect the medical education funding in order to support the nurse residency implementation programs. The centers for Medicaid Services and Medicare, Services Administration, Health Resources and Health care organizations together with philanthropic organizations need to increase their funding and get involved in the implementation and development of nurse residency programs. The healthcare organizations should work towards evaluating the efficiency of the programs of nurse residency. Similarly, several foundations should also carry out an evaluation of the effectiveness of the expansion of competencies and the development of the results of the patients. Through these modes, the nurses will get better treatments and the programs will ensure that the level of healthcare provision will be high. Eventually, the service provision in the nursing profession will be efficient. Raise the percentage of nurses’ proportion with baccalaureate degree in 2020 to 80 percent The proportion of nurses having baccalaureate degree should be raised from 50 percent to 80 percent by the year 2020. This should apply to the academic nurse leaders, cutting across all the nursing schools. The educational nurse leaders are supposed to seek for partnerships with employers, public and private funders and various accrediting bodies in ensuring that there is adequate monitoring and funding. This will go a long way in increasing the students’ diversity in the creation of a workforce that is prepared to take on the diverse demands of the people. These demands cut across the lifespan hence the need for adequate preparation. The National League for Nursing Accrediting Commission together with Commission on Collegiate Nursing Education is supposed to insist on a definition of educational pathways by all the nursing schools. This definition should go beyond the agreements articulation and to promote the access of higher level of education for the nurses in a seamless manner. Those nurses holding diploma degrees and associate degrees are supposed to be encouraged by the healthcare companies to pursue baccalaureate nursing programs after five years of their graduation. This can be done through offering the nurses tuition reimbursement and by creating a continuing education culture. Moreover, the healthcare organization can also provide promotions and salary differential to the nurses to allow them pursue higher education in the nursing profession. Doubling the number of nurses having doctorate by 2020. The private funders together with the nursing schools should liaise with university trustees and the academic administrators to double the number of nurses having doctorate up by the year 2020. Through this action, the abilities of nurse researchers and faculty will be increased therefore leading to an increase and efficiency in variety. The National League for Nursing Accrediting Commission and the Commission on Collegiate Nursing Education is supposed to jumpstart an intensive monitoring progress of the different nursing schools that are accredited. This will ensure that there are at least 10 percent of graduates with baccalaureate that will be matriculated into the doctoral of masters programs after at least five years of their graduation. The funding should be expanded in order to offer graduate degrees at an accelerated speed. This will ensure that the number of nurses with doctoral and masters increase tremendously. The institutions that are supposed to aid in this funding include the Services Administration, Health Resources Administration, the Department of Labor and the public and private funders. By funding these educational programs, an increase will be seen in the number of researchers, scientists and nurse faculty. The university trustees and academic administrators should also create benefit and salary packages that are equally competitive in the market. Ensuring that nurses are engaged into lifelong learning programs. Various health professions, competency educators, health care organizations, nursing schools and accrediting bodies are supposed to collaborate in ensuring that the nursing students and nurses pursue further education. Moreover, the nursing students and nurses should be catapulted to pursuing lifelong learning programs to enable them gain the needed competencies and to provide healthcare that is efficient across the populations. Faculty should develop partnership with the healthcare organizations in prioritizing and developing competencies. The curricula should also be updated n a regular basis to factor in the changes, in the profession and to prepare the graduates in different levels for future and the current health needs of the people. All students of nursing are supposed to demonstrate that they have competencies, have skills and knowledge in care provision and have comprehensive performance. This is supposed to be impressed upon the students by the National League for Nursing Accrediting Commission and the Commission on Collegiate Nursing Education. The faculty should also participate in fostering lifelong learning culture and be able to provide for inter-professional resources. An evaluation of competency programs that are in continuity should be carried out by healthcare organizations (World Health Organization, 2010). Enable and prepare nurses to lead advance health change. The nursing associations, v and nurses, are supposed to work towards preparing the workforce of the entire nursing fraternity to take up the positions of leadership across the different levels. On the other hand, the governmental, private and public healthcare decision shapers are to ensure that nurses fill in the leadership positions that are available. Nurses are supposed to take responsibility for their own professional and personal growth through exploring new opportunities and furthering their education levels. In this manner, they will be able to exercise and to develop their skills in leadership. Mentoring programs, leadership development and several opportunities should be provided by the various nursing associations. An integration of programs on nursing education and business and leadership theories will work well towards engaging and making nurses more efficient in their service provision, in the healthcare systems. All the decision makers in the governmental, private and the public healthcare are supposed to include nurses or representatives from the nurses’ boards and incorporate them into key leadership positions. Building infrastructure for the study and collection of health care workforce data. An effort towards the development of research, study and the collection of data pertaining to the requirements of the healthcare workforce should be led by the Government Accountability Office, Health Resources and Services Administration and the National Health Care Workforce Commission. The Health Resources and Services Administration together with the Workforce Commission should work towards coordinating and developing the standardization of the minimum data, setting across the several states. This also applies to the data set across the different professions. The Health Resources and Services Administration together with the Workforce Commission are supposed to set the standards for the minimum data collection set by the licensing boards of the state. They are also supposed to house, coordinate and oversee the release of the data vis-à-vis making it public to the populations. The two organizations should also work in liaison to provide a system of monitoring that applies the modern approaches of analysis of data from the set of minimum data. This should then be used in the measuring of the requirements of the nursing workforce. Workforce research should also be coordinated. The state nursing workforce, employers, regional and state educators, should also plan towards increasing the health professionals’ supply. The actual result of this report on the profession of nursing and the change For the healthcare employees to achieve a more impactful shift and development in the healthcare, must more serious approach. Some serious policies are supposed to be formulated, away from the soft policies that were set by the committee. Such drastic policies that will improve and change the health care system include rewarding the nurses who have sacrificed and worked for the BSN alongside offering wages that make the nurses feel rewarded for completing their degrees. However, the probability of the employers adjusting and adopting these hard policies will greatly depend on the number of nurses that shall be available in the market. The demand and supply of the nurses will impact on the way and the urgency of the implementation of these policies. In the IOM, the nurse residency program is essential in offering skills to the newly minted nurses. However, most of these nurses, usually around 36 percent to 65 percent, change their profession within the first year of employment. This has led to the escalation of costs in the hospitals and other health care providing facilities. In conclusion, there is an opportunity for the United States f America to transform its healthcare systems. Moreover, the nurses should, and indeed play a vital role in the performance of this transition. However, the performance of a set or proposes regulations do not lie with the nurses alone. There are many other stakeholders that come in and whose efforts and contributions are needed. A change in the healthcare system can be achieved but only through a consolidated effort from all the stakeholders. The report has several recommendations that are directed to like the nurses and different organizations. References Institute of Medicine. (2010a). The future of nursing: Leading change, advancing health. Washington, DC: The National Academies Press. Institute of Medicine. (2010b). Redesigning continuing education in the healthcare professions. Washington, DC: The National Academies Press World Health Organization. (2010). Framework for action on interprofessional education and collaborative practice. Geneva: Author Read More