Recommendations
The Future of Nursing Initiative
2010-2020
The Future of Nursing initiative is rooted in the recommendations of the 2010 report, The Future of Nursing: Leading Change, Advancing Health from the Institute of Medicine (IOM) and the Robert Wood Johnson Foundation (RWJF). The eight recommendations contained in the report are:
Recommendation 1:
Remove scope-of-practice barriers.
Advanced practice registered nurses should be able to practice to the full extent of their education and training.
Recommendation 2:
Expand opportunities for nurses to lead and diffuse collaborative improvement efforts.
Private and public funders, health care organizations, nursing education programs, and nursing associations should expand opportunities for nurses to lead and manage collaborative efforts with physicians and other members of the health care team to conduct research and to redesign and improve practice environments and health systems. These entities should also provide opportunities for nurses to diffuse successful practices.
Recommendation 3:
Implement nurse residency programs.
State boards of nursing, accrediting bodies, the federal government, and health care organizations should take actions to support nurses’ completion of a transition-to-practice program (nurse residency) after they have completed a prelicensure or advanced practice degree program or when they are transitioning into new clinical practice areas.
Recommendation 4:
Increase the proportion of nurses with a baccalaureate degree to 80 percent by 2020.
Academic nurse leaders across all schools of nursing should work together to increase the proportion of nurses with a baccalaureate degree from 50 to 80 percent by 2020. These leaders should partner with education accrediting bodies, private and public funders, and employers to ensure funding, monitor progress, and increase the diversity of students to create a workforce prepared to meet the demands of diverse populations across the lifespan.
Recommendation 5:
Double the number of nurses with a doctorate by 2020.
Schools of nursing, with support from private and public funders, academic administrators and university trustees, and accrediting bodies, should double the number of nurses with a doctorate by 2020 to add to the cadre of nurse faculty and researchers, with attention to increasing diversity.
Recommendation 6:
Ensure that nurses engage in lifelong learning.
Accrediting bodies, schools of nursing, health care organizations, and continuing competency educators from multiple health professions should collaborate to ensure that nurses and nursing students and faculty continue their education and engage in lifelong learning to gain the competencies needed to provide care for diverse populations across the lifespan.
Recommendation 7:
Prepare and enable nurses to lead change to advance health.
Nurses, nursing education programs, and nursing associations should prepare the nursing workforce to assume leadership positions across all levels, while public, private, and governmental health care decision makers should ensure that leadership positions are available to and filled by nurses.
Recommendation 8:
Build an infrastructure for the collection and analysis of interprofessional health care workforce data.
The National Health Care Workforce Commission, with oversight from the Government Accountability Office and the Health Resources and Services Administration, should lead a collaborative effort to improve research and the collection and analysis of data on health care workforce requirements. The Workforce Commission and the Health Resources and Services Administration should collaborate with state licensing boards, state nursing workforce centers, and the Department of Labor in this effort to ensure that the data are timely and publicly accessible.
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AREAS OF FOCUS
The Campaign for Action is working on both the national level and in every state, engaging with consumers, nurses, other clinicians, insurers, health care systems, employers, educators, funders, and public policy makers—all the stakeholders who need to be involved in system change.
Guided by the eight IOM recommendations, our work is focused on five areas. They are:
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Leadership: We need to expand the ability of nurses to influence system change on management teams, in boardrooms, policy debates, and within our communities.
Practice and Care: America is faced with a shortage of primary care physicians and increasing health care costs. As the largest number of health professionals, the nation’s three million nurses can transform the health care system and are pivotal to efforts to provide access to care for patients. We need to remove barriers that limit nurses and other providers from practicing to the full level of their education and training.
Education and Training: To prepare nursing to meet the challenges of the future, we need to strengthen nurse education and training. This will ensure that current and future generations of nurses can deliver safe, quality, patient-centered care across all settings.
Interprofessional Collaboration: Interprofessional collaboration improves individual and population outcomes, and quality indicators. As the delivery of care becomes more complex, and the need to coordinate care among physicians, nurses, pharmacists, social workers and others becomes ever more important, training professionals to work in well-functioning teams is essential.
Diversity: We need a nursing workforce that better reflects our patient population and that can provide culturally appropriate services. In other words, we need to recruit and educate the nursing workforce of the future.