Introduction
Many nurses take pride in the practice of their nursing career. They are committed to advocate for the safety and quality patient care and they are supporting any reform of health delivery system that can go an extra mile to promote the nursing practice. The Nurses Day celebrations are received by a large population in a well orchestrated, thus, showing that nurses are the largest trusted workforce in the United States of America. The report released by the Institute of Medicine (IOM) in the year 2010 in their article entitle ‘The Future of Nursing: the Leading Change, Advancing Health’, made the majority of the nurses feel iconize about this very impressive body focusing on nursing. That article was calling for an increase of the nurse workforce by 80 percent BSN-prepared by 2020. According to that report, the nurse workforce which was standing at 50 percent of the nurse workforce was having BSN (Edwards, 2016). The success of increasing the BSN percent of the nurse workforce is part and parcel of the IOM recommendation in that report which is targeting to double the number of prepared nurses by the year 2020. It is then very inevitable to fulfill the goals of IOM nurse workforce without passing legislation requiring that new nurses should earn the BSN within a rational duration (Edwards, 2016). Healthcare facility with higher proportions of staffs with Bachelor of Science or Master of Science in Nursing exhibits a higher productivity and enhanced patient outcome. It was found out that a 10% increase of the ratio of baccalaureate-prepared nurses on nursing units was linked with reducing the unusual patient mortality by 10.9% (Rosseter, 2015). It means then that by increasing the number of care provided by BSN-prepared nurses to 80% would consequently lead to significant shorter lengths of stay and lower readmission rates. This result will subsequently result in costs saving that would be greater than expenses incurred in increasing the number of BSN-prepared nurses in hospital scenarios.
The need to prepare a healthy nursing workforce in the United States lead to the production of Institute of Medicine report titled ‘The Future of Nursing: Leading Change, Advancing Health’ which was released in 2010. The journey to this landmark report began in the year 2008 when the Institute of Medicine (IOM) together with the Robert Wood Johnson Foundation (RWJF) undertook the most important initiative of carrying out a study on the Future of Nursing. The main objective of the study was to come up with transformational information on the future prospective of nursing (National Academy of Sciences, 2015). The two institutions collaborated and came up with an ad hoc committee that looked at the capabilities of nursing personnel to meet the stipulations of the reformed healthcare and the public health delivery system
Recommendations
The report recommended four major concerns that needed immediate action if the expected changes in nursing were to be realized. One of the recommendations was that nurses should be allowed to practice the full scope of their educational qualifications and training. For this to take place, policy and regulatory barriers limiting nurses’ ability to initiate transformations should be removed. The second recommendation of the report focused on the need of higher education qualifications and training among nurses. This goal can be realized through an enhanced education system that allows flawless academic progression from one level to another (National Academy of Sciences, 2015). Thirdly, the committee recommended that nurses should partner fully with physicians and all other professionals in healthcare transformations in U.S. The fourth and last recommendation of the IOM report is the need for improved data collection and information communication for an effective personnel and policy making.
Increase the proportion of nurses with baccalaureate degree to 80% by 2020
One of the IOM report recommendation is to make sure nurses achieve higher levels of education and adequate training through an advanced education system that would enhance seamless academic progression and earn them BSN by 2020 (Kovner et al., 2013). There is a need to provide highly-educated nurses since the health challenges facing the nation have drastically shifted; for example, the aging population is increasing with time. This will come along with a more diverse racial, ethnicity, cultural and socioeconomic factors (McEwen, 2015). In addition to nation’s demographics shift, there will be a shift of the nationwide health care needs. The current U.S health care system was fundamentally built around treating acute injuries and illnesses relating to chronic conditions such as hypertension, mental health, diabetes and arthritis based on the 20th century education system. That knowledge which was gained based on education of 20th century is currently not adequate enough to address the realities of the health care needs of the 21st century (Institute of Medicine of the National Academies, 2010) . This is due to the fact that the care environment and patients needs are increasingly becoming complex and as such, nurses need to attain the required competencies to deliver safe and high-quality care. These competencies include health policy, leadership, research, teamwork and collaboration, evidence-based practice, public health, community health, geriatrics and system improvement (Altman et al., 2016). Nurses are being encouraged to rise up to master information and technological tools management systems and fill the expanding roles while at the same time coordinate and collaborate with all other teams of health care professionals (Warshawsky et al., 2015). To respond and achieve these demands, the IOM committee is recommending that nurses should attain higher levels of education that have been streamline to the 21st century education system that would better prepare them to meet the needs of the population (Institute of Medicine of the National Academies, 2010).
Action taken as a result of IOM report
One of the actions that have been taken to realize the vision of increasing the number of BSN-prepared nurses by 2020 is changing the nursing education to ensure continuity from diploma to masters.
Secondly, there is a need to improve the education system to incorporate public health, long-term and primary care (Institute of Medicine of the National Academies, 2010).
Thirdly, the nursing education system should adopt a continued lifelong learning system that will give opportunities for nurses and nursing students to engage in a seamless transition to higher degree programs (Edwards, 2016). The educational pathways and bridge programs between graduate and undergraduate programs such as AND-to-BSN, AND-to-MSN and LPN-to-BSN are planned to aid academic progression to advanced levels of education. Furthermore, the nursing schools and any other relevant groups are required to create programs that recruit and retain individuals from the ethnic and racial minorities as well to increase the number of men in the nursing profession (McEwen, 2015).
Fourthly, enough nurses with right skills should be employed (Institute of Medicine of the National Academies, 2010). This is due to the fact that having the right number of the nurses with the right skills will significantly contribute to the overall quality and safety of a renovated health care system (Edwards, 2016).
Lastly, assist fresh nursing graduates to develop technical and leadership skills needed to provide quality care.
Barriers
One of the barriers which are preventing the provision of quality and satisfactorily health care is a high turnover rate which has been ever destabilizing the nursing workforce in the U.S (Institute of Medicine of the National Academies, 2010). This has significantly increases associated costs, more so in nursing homes and hospitals. This call for a need to focus on the development of programs that will address management of the transition from school to practice so as to curb high turnover rate among newly graduated nurses (Kovner et al., 2013). One of those programs is nurse residency programs which are planning and giving a comprehensive period of time to newly nursing graduates so as to facilitate them with skills and knowledge required to deliver quality and safe care that meets identified standards of nursing practice.
Nursing education is neither addressing the issue of care transitions and coordination nor promoting the skills required to determine the eligibility of the patients to enroll in social and health services programs and negotiate with other health care teams (Altman et al., 2016). Therefore, there is need to re-examine and update the nursing curricula that will be well enough adapt to ever changing needs of the patients and expansion in science and technology American Association of Colleges of Nursing. (2016). New educational models and approaches have to be developed to counter the flourishing information as opposed to rote memorization. To make these programs realized, the state and the federal governments should provide financial support that includes funding for scholarships and grants for nurses wishing to enroll in these programs (Institute of Medicine of the National Academies, 2010).
Conclusion
In order to meet the ever increasing demand for nurses in health care services and replace those who are set to retire, a road map must be put in place to ensure that community nursing colleges; four-year nursing institutions and universities produce more qualified nurses. This goal can only be achieved by raising the education levels to the baccalaureate degree for those who intend to join the nursing practice profession. Furthermore, students leaving college ought to be educated on how to handle transition period from college life to workplace environment to avoid high turnover rates in nursing. The education curriculum should also ensure emerging issues that are required to deal with team leadership, system thinking, decision making and quality improvement competencies is a component of every nurse’s professional education.
References
Altman, S. H., Butler, A. S., & Shern, L. (Eds.). (2016). Assessing Progress on the Institute of Medicine Report The Future of Nursing. National Academies Press.
American Association of Colleges of Nursing. (2016). American Association of Colleges of Nursing | Joint Statement on Academic Progression for Nursing Students and Graduates. Retrieved from http://www.aacn.nche.edu/aacn-publications/position/joint-statement-academic-progression
Edwards, D. S. (2016). An 80% BSN workforce by 2020? Retrieved from http://www.reflectionsonnursingleadership.org/Pages/Vol38_1_Edwards_IOM%20Report.aspx
Kovner, C. T., Lee, C. H., Lusk, E. J., Katigbak, C., & Selander, N. (2013). Sustainability of the IOM 80/20 Nursing Initiative as Viewed through a Decision Support System Supporting" What-If" Benchmarking Capabilities. Journal of Management and Sustainability, 3(3), 25.
McEwen, M. (2015). Promoting Differentiated Competencies Among RN-to-Bachelor of Science in Nursing Program Graduates. Journal of Nursing Education, 54(11), 615-623.
National Academy of Sciences. (2015). Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the Institute of Medicine. Retrieved from www.nationalacademies.org/hmd/Activities/Workforce/Nursing.aspx
Rosseter, R. (2015). American Association of Colleges of Nursing | Creating a More Highly Qualified Nursing Workforce. Retrieved from http://www.aacn.nche.edu/media-relations/fact-sheets/nursing-workforce
Warshawsky, N. E., Wiggins, A. T., Lake, S. W., & Velasquez, C. (2015). Achieving 80% BSN by 2020: Chief Nurse Executive Role and ANCC Influence. Journal of Nursing Administration, 45(11), 582-588.
