Introduction
The scope of nursing profession is changing drastically with advancement in medical technology, an aging patient population, newer communicable and non-communicable diseases and new challenges brought on by regulatory legislation.1 The nursing profession is under pressure to undergo change accordingly to ensure that hospitals and other organizations are able to continue to provide the best possible care to their patients, community and for the needy.As a nursing professional, you make sure that patient care keeps pace with changes within the field.2 Part of that responsibility requires staying au courant industry developments to form sure that you simply are up so far with the newest and greatest in clinical practice. There are few trends that are responsible for changing the future of nursing: Shifting demographics, increasing leadership opportunities, growing role of informatics, increasing emphasis on population health, different settings, growing need for education. The profession of Nursing is merely focused on the care of people or families or communities with an aim of achieving, maintaining or recovering optimal health and therefore the quality of life.3 The profession of Nursing is based on the authority of one contract which describes or portrays the professional rights and responsibilities in conjunction with mechanisms for public accountability.4 The entrance to the present profession is controlled by the national or state level. Maintaining the credentials, code of ethics and standards while still ensuring quality care of the individuals is one among the most focuses of the Nursing profession.5, 6, 7 The roads of education for Nursing are different and vary greatly everywhere the planet.
Background
In 2008, The Robert Wood Johnson Foundation (RWJF) approached the IOM to determine a two years Initiative on the longer term of Nursing, with the first mission of developing a report containing recommendations for an action-oriented blueprint for the end of the day of nursing, including changes publicly and institutional policies at the national, state, and native levels. to supply this report, a committee examined and produced recommendations related to the next issues, with the goal of identifying vital roles for nurses in designing and implementing a simpler and efficient health care system:
Reconceptualizing the role of nurses within the context of the whole workforce, the shortage, societal issues, and current and future technology.
Expanding nursing faculty, increasing the capacity of nursing schools, and redesigning nursing education to assure that it can produce an adequate number of well-prepared nurses ready to meet current and future health care demands.
Examining innovative solutions associated with healthcare delivery and health care provider education by that specialization in nursing and therefore the delivery of nursing services.
Attracting and retaining well prepared nurses in multiple care settings, including acute, ambulatory, medical aid, future care, community and public health.
IOM Recommendations
The American Nurses Association (ANA) appreciates all the recommendations of the Institute of drugs (IOM), 2010 for improving the nursing standards and accepts the four main recommendations within the Nursing practice. consistent with this report ANA believes that these recommendations are essential for meeting the stress of our changing health care system. The report is that the results of the Initiative on the longer term of Nursing, sponsored by the Robert Wood Johnson Foundation. Among the report’s recommendations;
Nurses should practice to the complete extent of their education, training and licensure. Remove scope-of-practice barriers. Advanced practice registered nurses should be ready to practice to the complete extent of their education and training.
Nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression. Expand opportunities for nurses to steer and diffuse collaborative improvement efforts. Private and public funders, health care organizations, nursing education schemes, and nursing associations should expand opportunities for nurses to steer and manage collaborative efforts with physicians and other members of the health care team to conduct research and to revamp and improve practice environments and health systems. These entities should also provide opportunities for nurses to diffuse successful practices. ANA’s Nursing: Scope and Standards of Practice, 2nd edition, (2010), speaks.
Nurses should be full partners, with physicians and other health professionals, in redesigning health care within the us. Implement nurse residency programs. State boards of nursing, accrediting bodies, the federal, and health care organizations should take actions to support nurses’ completion of a transition-to-practice program (nurse residency) after they need completed a prelicensure or advanced practice course of study or once they are transitioning into new clinical practice areas.
Effective workforce planning and politics require better data collection and an improved information infrastructure. 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 extend 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 make sure funding, monitor progress, and increase the range of scholars to make a workforce prepared to satisfy the stress of diverse populations across the lifespan.
Discussion
The question presented to the committee that produced this report was: What roles can nursing assume to affect the increasing demand for safe, top quality , and effective health care services, IOM recognized that the new health care laws would require ways to deal with challenges within the management of chronic conditions, medical care (including care coordination and transitional care), prevention and wellness, and therefore the prevention of adverse events (such as hospital-acquired infections). The report also identified the demand for better provision of mental state services, school health services, long-term care, and palliative care (including end-of-life care) is increasing also.
Accordingly, IOM noted that nursing brings to the longer term a steadfast commitment to patient care, improved safety and quality, and better outcomes. In fact, the report asserts that the majority of those challenges speak to traditional and current strengths of the nursing profession in such areas as care coordination, health promotion, and quality improvement. As a result, IOM emphasized that “nurses have key roles to play as team members and leaders for a reformed and better-integrated, patient-centered health care system.
In order to expand the role of nurses, the report first recognizes the necessity to permit nurses to practice in accordance with their professional training. IOM also recognized the necessity for nurse education to “better prepare them to deliver patient-centered, equitable, safe, high-quality health care services; engage with physicians and other health care professionals to deliver efficient and effective care; and assume leadership roles within the redesign of the health care system.” Consequently, IOM asserted that “an expanded workforce to serve the millions who will now have access to insurance for the primary time will require:
Changes in nursing scopes of practice
Advances within the education of nurses across all levels
Improvements within the practice of nursing across the continuum of care
Transformation within the utilization of nurses across settings, and
Leadership within the least levels so nurses are often deployed effectively and appropriately as partners in the health care team.
IOM received these recommendations by acknowledging the unique role that nurses play within the health care system. Because nurses have regular and shut proximity to patients and scientific understanding of care processes across the continuum of care, they have a singular ability to act as partners with other health professionals and to steer within the improvement and redesign of the health care system and its many practice environments, including hospitals, schools, homes, etc. In addition, the recommendations reflect the facility of nurses to help bridge the gap between coverage and access, to coordinate increasingly complex take care of an honest range of patients, and to enable the complete value of their contributions across practice settings to be realized. This includes nurse’s crucial role in preventing medication errors, reducing rates of infection, and even facilitating patients’ transition from hospital to home.
Nursing practice covers a broad continuum from health promotion, to disease prevention, to coordination of care, to cure—when possible—and to palliative care when cure isn't possible. However, IOM acknowledged that “many members of the profession require more education and preparation to adopt new roles quickly in response to rapidly changing health care settings and an evolving health care system.”
The recommendations also recognize how restrictions on scope of practice, policy- and reimbursement-related limitations, and professional tensions have undermined the nursing profession’s ability to provide and improve both general and advanced care. As a result, IOM asserts the need to transform the work environment, scope of practice, education, and numbers of America’s nurses by creating a health care system that delivers the proper care—quality care that's patient centered, accessible, evidence based, and sustainable—at the proper time.
Conclusion
In conclusion, the IOM recommendations were initiated to satisfy the increasing health needs of diverse populations across the country and changing the role and responsibilities of nurses accordingly. 8 In consideration with these, the ANA need to expand the role of nurse to handle the changing health trends (patient centred care). The role of continuous education (CE) are going to be crucial in realizing the IOM recommendations. Not only will CE for nurses got to cover more areas of coaching and education9, it'll also got to specialise in team-based approaches for collaborating with other physicians, which also means CE for physicians will need to specialise in interacting with nurses. Accordingly, CE must play a critical role in realizing the potential benefits of health care reform by improving the role nurses play within the health care system and improving patient outcomes.
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