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In 2008, The Robert Wood Johnson Foundation (RWJF) and the Institute of Medicine (IOM) launched a two-year study to assess the current state and provide recommendations for transforming the nursing profession. The following key mes- sages and recommendations provide a synopsis of the report from the Committee on the RWJF Initiative on the Future of Nursing at the IOM. These recommendations provide an action-oriented blueprint for the future of nursing.

IOM KEY MESSAGES As a result of its deliberations, the IOM committee formu-

lated four key messages that structure the discussion and recom- mendations presented in this report:

1. Nurses should practice to the full extent of their educa- tion and training.

2. Nurses should achieve higher levels of education and training through an improved education system that pro- motes seamless academic progression.

3. Nurses should be full partners, with physicians and other health professionals, in redesigning health care in the United States.

4. Effective workforce planning and policy-making require better data collection and an improved information infra- structure.

IOM RECOMMENDATIONS 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 collabora- tive 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 prac- tices. 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 preli- censure 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 nurs- ing 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 bod- ies, private and public funders, and employers to ensure fund- ing, 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 sup- port 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 increas- ing diversity. Recommendation 6: Ensure that nurses engage in lifelong learning. Accrediting bodies, schools of nursing, health care organizations, and continuing competency educa- tors 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 educa- tion programs, and nursing associations should prepare the nursing workforce to assume leadership positions across all lev- els, while public, private, and governmental health care deci- sion makers should ensure that leadership positions are avail- able 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 Accountabil- ity Office and the Health Resources and Services Administra- tion, 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.

IOM Report on the Future of Nursing: Leading Change, Advancing Health

Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the Institute of Medicine

Reprinted with permission from The Future of Nursing: Leading Change, Advancing Health (2010), by the National Academy of Sciences, courtesy of the National Academies Press, Washington, DC.

http://www.thefutureofnursing.org • http://www.nap.edu/catalog/12956.html

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