Benchmark Assignment: Implementation of the IOM Future of Nursing Report
With over 3 million practitioners, the profession of nursing forms the largest section of
the US’s health care workforce. Nurses play a central role in assisting patients in realizing the
objectives of the Affordable Care Act, a legislation that forms a wide range of health care
overhaul since the creation of Medicare and Medicaid. However, some obstacles have hindered
nurses from effectively responding to the ever changing clinical settings as well as an evolving
health care system. These challenges include shortage of nurses, technological changes, and
shortage of educational opportunities for nursing. These barriers need to be addressed so that
nurses can be in the best position of leading change and advancing health.
Work of RWJF Committee Initiative
Robert Wood Johnson Foundation (RWJF) in conjunction with the Institute of Medicine
(IOM) established a major initiative that has served as a guide in the future of nursing. RWJF
partnered with IOM in conducting a study and developed a report meant to transform the future
of nursing. The IOM committee through this study determined potential challenges that were
facing the nursing profession and compiled a report on the modifications in institutional policies
at the local, state, and national levels. RWJF through the IOM’s study committee reviewed
innovative models of nursing education and care delivery and provided solutions that could be
used to improve the quality of care delivery at an affordable cost.
RWJF established the initiative of the “Future of Nursing” that examined the potential of
promoting the quality and accessibility of care through the use of nursing-led solutions. The
report had recommendations geared towards determining significant roles for nurses in planning
and executing an effective and efficient health care system.
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Some of the recommendations that were highlighted in the report include examination of
innovative solutions associated with delivery of care and nursing education with a focus on
nursing and provision of patient care. It was also recommended that the nursing faculty should be
expanded, capacity of schools increased, and nursing education be redesigned in order to ensure
that it produces a sufficient number of well-prepared nurses that are able to meet health care
demands. Fineberg & Lavizzo-Mourey, (2013) state that clinical and community care in the US
has become more complex. Therefore, the education provided should equip nurses so that they
can make important decisions linked to care for frail patients and work with sophisticated, life-
saving technology. The report also pointed out that the role of nurses within context of the health
care workforce, future technology, nursing shortage, and societal issues should be re-
conceptualized. Nurses are called upon to collaborate with different health care professionals and
coordinate care across different settings. Moreover, the committee proposed that for improved
patient outcomes to be realized, the health care sector should attract and retain competent nurses
in different care settings such as acute, primary care, ambulatory care, long term care, public, and
The RWJF used the report in its extensive communication in conjunction with the IOM.
To support the initiative, the RWJF sponsored a team of experts who discussed the issues raised
by the IOM committee. The IOM also played a vital role in the development of the report. For
instance, it provided evidence-based proposals to clinicians, private stake holders as well as the
general public and provided independent, objective, and technical advice to policymakers.
Additionally, the IOM ensured that the recommendations that were developed had an agenda that
was clearly defined with an action plan that was properly formulated.
The Importance of the IOM Report
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The recommendations provided by the IOM in report center around vital intersection
between the actions of the nursing workforce and the health care needs of different people across
the lifespan (Reed, 2015, November). They are meant to promote the efforts of improving the
health of the people of US through contributions of nurses. They have an impact in various
nursing aspects such as;
i) Nursing Practice
Nurses have a great potential of leading innovative strategies tailored towards improving
the health care system. However, a number of state regulations limit the scope of nursing
practice. Depending on the state, regulations on scope of nursing practice of a RN may deny or
limit prescriptions of medications, admission of patients, assessment of patient conditions, and
evaluation of tests. However, the IOM report insists that nurses should provide care to the full
extent of their education and training. This has promoted delivery of quality care as nurses
provide necessary care with little limitation of the potential.
ii) Nursing education
Through the report, profound changes were introduced in nursing education both before
and after receiving license (Keating, 2014). This resulted in betterment of nursing education
which has ensured that the current and future generations of nurses provide quality, patient-
centered, safe, care across settings. Nurses have also been encouraged to act in response to the
demands of the ever-changing health care sector by attaining higher levels of education and
iii) Nursing workforce
To address the issue of nursing shortage, the implementation of the IOM report has led to
entry of a greater number of nurses with a baccalaureate degree early in their life. The report has
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also resulted in the transformation of the practice environment through a balance of skills and
perspectives among nurses and other health care providers.
Role of State-Based Action Coalitions and the Future of Nursing
States in the US have formed state-based coalitions that are aimed at enhancing the
implementation of the proposed IOM recommendations. These coalitions mobilize stakeholders
in the health care sector in order to promote the development of a clear plan of action. The state
of New York has been in the frontline in shaping the future of nursing practice. For instance, it
has adopted an initiative that is geared towards promoting nursing education for it to be in line
with set standards necessitate so that is can meet the complex nature of the health care sector
(Campaign for Action, 2014). The initiative also proposes that nurses should take up leadership
roles for promotion of the health care system. The objective of this initiative is to make sure that
nurses know their roles as leaders and the public acknowledges the competence of nurses when
promoting strategies. The state of New York has also built a strong and highly-competent
nursing workforce. These initiatives have given the state’s nurses the opportunity of contributing
actively in the promotion of care delivery.
The state of New York has been barred by barriers which limit proper advancement of
IOM recommendations. One such barrier is the shortage of nursing workforce. This has resulted
in overworking of the nursing leading to job burnout which in turn prevent delivery of quality
patient care. It is also important to note the insufficient of nursing workforce has also resulted in
an increase in hospitalization cases. Nursing advocates can play a central role in ensuring that the
IOM recommendations are achieved. For instance, the advocates can engage actively in decision
making processes that will introduce transformational policies in the health care sector. The
barrier of nursing shortage can be addressed through increasing admission of undergraduate
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nursing students and increasing nursing schools. The policies should also target nursing
education so that it can enlighten the nurses on how to deliver quality care despite the myriad of
challenges facing the health care sector.
The US has the potential of transforming its health care sector and nurses should
contribute majorly in this transformation. The IOM report has been essential in the health care
sector as it calls on nurses to play a central role in America’s increasingly multifaceted health
care system. Moreover, nurses have been urged to adopt leadership roles in all care settings so
that they can satisfy the demands of the evolving health care. The health care delivery
competencies has enabled nurses to examine the likely evolution of the health care sector,
evaluate their career goals, and determine what should be done to achieve the set objectives.
Some of the interventions that have been put forward include advancement of academic
education, continuing education, as well as certification. These advancements have been
necessary in equipping nurses with appropriate skills for tackling the challenges they encounter.
However, the efforts of improving the organizational conditions not only rest solely on nurses
but also on health care organizations, the government, insurance industry, and professional
associations. Collaboration of these diverse parties will help in ensuring that the health sector
offers affordable, seamless, quality care that is easily accessible.
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Campaign for Action. (2014). Transforming nursing education. Retrieved from
Fineberg, H. V., &Lavizzo-Mourey, R. (2013). The future of nursing: A look back at the
landmark IOM report.
Keating, S. B. (2014). Curriculum development and evaluation in nursing. Springer Publishing
Reed, J. (2015, November). Creating a Culture of Health: Opportunities for Public Health
Nursing to partner with State Action Coalitions. In 143rd APHA Annual Meeting and
Exposition (October 31-November 4, 2015). APHA.