Robert Wood Johnson Foundation Committee Initiative.
Introduction.
The increased demand for nursing care originating from the healthcare reforms and the advanced improvements in the increasingly complex healthcare system in America calls for a change in the nurses’ roles, education and responsibilities as well. The nursing staff is forming more than 3 million of the entire healthcare staff hence make a sizeable working force (Nardi & Gyurko, 2013). At the same time, they form the primary caregivers to patients since they spend the greatest amount of time in delivering their care. W2ith all this taken into account, it is definite that nurses have the highest capacity in quality improvement and safety development in the care given to patients. This can be achieved by various initiatives ventured towards the nursing care provision as displayed by the Robert Wood Johnson foundation committee initiative at the Institute of medicine as well as the work of the North Carolina Action Coalition as illustrated in this article.
While carrying out their work, the committee on the Robert Wood Foundation Initiative on the future of nursing came up with a vision for a transformed health care system. This vision catered for a future health care system which was meant to make quality care services accessible to various populations in the United States, enhance wellness and prevention of diseases, improve the health outcomes and provide holistic care across the population composition.
To meet their vision, the initiative place primary care and prevention as the critical drivers in the healthcare system. This was going to act as the health promotion aspect of the system by curbing conditions before they develop ((Nardi & Gyurko, 2013).). Interprofessional collaboration and coordination were also taken into account and was meant to ensure proper communication among the caregivers to ensure teamwork and make the quality of care better.
Apart from the concentration on the healthcare provide3rs, the initiative also considers the payments for the services being provided. They aimed at the payments being a reward for the quality care given and not the volume of such services (Hickey et al., 2014). The rate of growth of the healthcare expenditure was also required to slow down. These changes were to mark the desired healthcare system which was to be patient-centered care that responds to the needs of various individuals.
Robert Wood Johnson Foundation approached the institute of medicine in the year 2008 for a partnership in achieving their goal of transforming the nursing profession. The two came together and developed an initiative of future of nursing since the nursing profession had challenges in fulfilling the promise of the reformed health care system. The initiative came up with recommendations that were action-oriented issues for the future of nursing. The key issues that were recommended include the following messages:
- Nurses to be able to practice to the full extent of their education and training.
- Nurses to be able to achieve an advanced level of education as well as training via an improved education system that would the end lead to the promotion of academic progression.
- Nurses to be part of the redesigning of the healthcare system in cooperation with physician s and other healthcare professionals.
- Better data collection together with improved information infrastructure would allow for effective workforce planning and policy making (Hickey et al., 2014).
The messages from the report dwelt on three issues which form the basis of a report by the Institute of medicine. Regarding transformation of the nursing education, the report was significantly based on its recommendation for the achieving better levels of education and training by nurses’ which has been achieved to enhance academic progression by nurses. Through this, various avenues have been put in place to register nurses and allow their practice. These entail range of ways such as baccalaureate degree program, associate degree in diploma and hospital-based diploma.
The report was also important in that it has ensured the quality of care provision has improved. With the recognition of many changes in the healthcare system and need for highly trained and experienced nurses, the report recommended nurses to have a minimum requirement of bachelor’s degree for one to get to nursing practice. This was to provide a raised level of nursing care that is also uniform.
The report by the Institute of Medicine encouraged nurses in the lower cadres to enter the bachelor’s program to meet their aim of having 80% of the nursing staff to have a bachelor degree in nursing by 2020(National Academies of Sciences, Engineering, and Medicine, 2016). They enabled this by offering reimbursement for the tuition fee hence creating a culture favoring further education. At the same time, the report has impacted nursing education positively by enabling regular updating of the nursing curriculum to incorporate changes that may be needed in the care being provided.
For nursing practice, the report is essential in that it impacted the primary health care. With the report advocating for 80% of the nursing staff being degree holders, the quality of care provided by the nurses have improved markedly right from the primary level of care provision. Expertise and improved training have also seen nurses at the primary level of care embracing and using the evidenced-based practices to care for their patients.
Still, in the nursing practice, the report has enabled provision of various care services that are essential at the primary care levels yet have always not been provided since they do not fall within the nursing scope. These have been attributed to the regulatory and policy barriers that deterred nurses from carrying such services out (National Academies of Sciences, Engineering, and Medicine, 2016). With the report advocating for independent practice by nurses without supervision from physicians, their scope has been expanding. Hence patients can receive various services at grass root level. Concerning the nursing workforce development and leadership, the report has empowered nurses to be agents of change and participate fully in the redesigning of the healthcare system.
Besides the actions by the Robert Wood Johnson Foundation Committee Initiative, actions developed in various states have also natured the future of nursing. In North Carolina, the North Carolina Action Coalition formed a basis for the transformation of the healthcare provision with the nurses placed at the forefront in building healthier communities hence performing key functions in shaping the future of nursing. The North Carolina Action Coalition has brought more nurses on board to be members of their team to call for transformation in unison (Edwards et al., 2014). The coalition has launched coalition related programs that has spearheaded the many educated nurses in the state. Between 2009 and 2013, the coalition have marked a 4% increase in nurses with bachelor’s degree in nursing. Besides, North Carolina has contributed to 312 of the 10,000 nurses’ boards by 2020 by encouraging workshops, training, and mentorship. These initiatives have seen North Carolina focused on improving the nursing care provided in the state.
With the initiative of the coalition for action, North Carolina still experience the regulatory and policy barriers that impact nursing practice. The scope of practice limitation and workforce priorities interfered with the service being rendered to the people. To deal with these, nurse advocates need to take up the policy issues and campaign for policy development and a change concerning the above barriers.
The nurses’ advocates can use the parliamentary path and use a legislator to express their concern. At the same time, they can use experts such as lawyers to spearhead the nursing issues. At the same time, they can do communal advocacy by rallying people at the grassroots level to make the policy limitation an urgent issue to be taken into account.
Conclusion.
The work of Robert Wood Johnson Foundation Committee Initiative in conjunction with the Institute of Medicine has significantly impacted in shaping the future of nursing and ensuring a better healthcare system. The decentralization of implementation of the goals of the above initiatives has seen the development of various coalitions of actions which have transformed the nursing practice in the different states hence improved the healthcare system.
References:
Edwards, L. E., Radford, A. D., Albertone, D. M., & Rinker, J. (2014). Achieving “A Better
State of Health” Healthy North Carolina 2020 and the Center for Healthy North
Carolina. North Carolina medical journal, 75(6), 398-402.
Hickey, K. T., Hodges, E. A., Thomas, T. L., Coffman, M. J., Taylor-Piliae, R. E., Johnson-
Mallard, V. M., … & Gates, M. G. (2014). Initial evaluation of the Robert Wood Johnson
Foundation nurse faculty scholars program. Nursing outlook, 62(6), 394-401.
Nardi, D. A., & Gyurko, C. C. (2013). The global nursing faculty shortage: Status and solutions
for change. Journal of Nursing Scholarship, 45(3), 317-326.
National Academies of Sciences, Engineering, and Medicine. (2016). Assessing progress on the
Institute of Medicine report The Future of Nursing. National Academies Press.
