Nursing Practices Recommended in the IOM Report

Review the IOM report, “The Future of Nursing: Leading Change, Advancing Health,”
and explore the “Campaign for Action: State Action Coalition” website. In a 1,000-1,250
word paper, discuss the influence the IOM report and state-based action coalitions have
had on nursing practice, nursing education, and nursing workforce development, and how
they continue to advance the goals for the nursing profession.
Include the following:
1.) Describe the work of the Robert Wood Foundation Committee Initiative that led to the
IOM report, “Future of Nursing: Leading Change, Advancing Health.”
2.) Outline the four “Key Messages” that structure the IOM Report recommendations.
Explain how these have transformed or influenced nursing practice, nursing education and
training, nursing leadership, and nursing workforce development. Provide examples.
3.)Discuss the role of state-based action coalitions. Explain how these coalitions help
advance the goals specified in the IOM report, “Future of Nursing: Leading Change,
Advancing Health.”
4.) Research the initiatives on which your state’s action coalition is working. Summarize
two initiatives spearheaded by your state’s action coalition. Discuss the ways these
initiatives advance the nursing profession.
5.) Describe barriers to advancement that currently exist in your state and explain how
nursing advocates in your state overcome these barriers.
You are required to cite to a minimum of three sources to complete this assignment.
Sources must be published within the last 5 years and appropriate for the assignment
criteria and relevant to nursing practice.

Nursing Practices Recommended in the IOM Report

The committee of Robert Wood Johnson Foundation (RWJF) came up with an initiative that
significantly contributed to the formulation of the Institute of Medicine (IOM) report dubbed
‘Future of Nursing: Leading Change, Advancing Health.’ The initiative, developed in 2010,
entailed a strategic vision that focused on the provision of guidelines which would be applied

across the various structures used in the delivery of care. Most fundamentally, it brought about
transformation if the American healthcare system by focusing on the different health issues that
affect the people (Institute of Medicine, 2018). As such, its formulation followed the emergence
of controversial perspectives regarding the Affordable Care Act (ACA) that advocated for the
improvement in the quality of care provided to the American citizens. For instance, following
congressional debates, the committee formulated a strategy that would improve the access of
affordable care to diverse communities in the United States.

Moreover, the attainment of the desired goals occurred through the optimization of the
improvement of the role of caregivers, notably nursing practitioners, in the provision of essential
care services. Consequently, the RWJF committee collaborated with the IOM to propagate a
future that optimized quality care as the basis of the US healthcare system. These were coupled
with the incorporation of values such as collaboration and coordination across interpersonal
operations that focus on effective delivery of affordable and quality health services. Similarly,
the committee partnered with the IOM in the initiation and establishment of a two-year strategy
aimed at improving the operations carried out by nursing practitioners (Institute of Medicine,
2018). In this initiative, the committee generated a report that outlined proposed a structure based
on actions that would shape the operations of nurses in the future. These recommendations
entailed the fundamental roles and responsibilities of nursing practitioners in the development, as
well as the implementation of effective and efficient care services.

Key Messages that have transformed or Influenced Nursing Practices

In the recent past, changes in the activities carried out by nursing practitioners and the
general health care system have led to complications based on complexities in patients’ needs,

and the dramatic shift to health operations that focus on a particular community. As such, these
changes have pointed out the essence of critical thinking regarding the delivery of adequate, safe,
as well as affordable health services to patients. As a result, the RWJF initiative optimized
improvement in the education provided to nurses as it would increase their experience,
knowledge, and skills, thereby promoting patient outcomes (The National Academies of Science
Engineering Medicine, 2018). According to the IOM report recommendations, the first key
message entails the enhancement of health services provided to the citizens through the
transformation in the nursing profession in a manner that the nursing practitioners have access to
higher levels of education and training that is suitable for the ever-changing environment
encompassing their operations.

Most fundamentally, the report instigated that approximately 80% of nursing
practitioners should have a baccalaureate degree as of 2020 (Institute of Medicine, 2018). This
requirement has thus significantly contribution to the restructuring of nursing practitioners,
education, and training by fostering quality care services associated with an extensive knowledge
base and the acquisition of competence in research. Moreover, it has influenced the advocacy for
advanced learning and quality practice by encouraging caregivers with expertise in distinct
disciplines to further their studies through BSN programs. Similarly, such factors have
transformed nursing practices through the preference for practitioners with skills acquired in
higher level institutions and who can handle common or complex health issues in the
contemporary world.

Subsequently, the IOM report recommended the increment in the employment standards
to the BSN level for willing practitioners and caregivers. This way, they would motivate and

encourage practitioners to improve their knowledge base and skills through the pursuit of
advanced education as well as the acquisition of necessary experience that would allow them to
carry out their operations in distinct settings (Institute of Medicine, 2018). The essence of this
message/ recommendation entailed the push for transformation and restructuring in the various
regulations that govern the scope of nursing practices across the nation. It thus sought to boost
the proportion of nursing practitioners tasked with the responsibility of providing necessary
health services and who cater to the ever-changing needs of their patients.

The third crucial message recommended by the IOM report entails equality in the
opportunities available to nursing practitioners to actualize and apply their expertise to the
extreme and in the same manner to their physician counterparts across the nation. In this
message, the IOM report advocated for nursing practitioners to take more responsibility in
making decisions and solving problems within their area of practice. However, the achievement
of this objective would occur through partnering with professionals from various disciplines to
develop standards of policies and guidelines that optimize the enhancement of safe and
affordable care operations (Institute of Medicine, 2018). Lastly, the IOM report recommended
that the entry-level of education in the nursing profession should be a Baccalaureate degree. It
thus transformed nursing practices, education, and training by ensuring compliance with the
requirement that approximately 80% of nursing practitioners should be bachelor’s degree holders
(The National Academies of Science Engineering Medicine, 2018). Regarding leadership and
workforce development, these recommendations facilitated the inclusion of nursing practitioners
in fundamental processes that involve making salient decisions and solving the emergent
problems at similar standards to other professionals in the healthcare system.

The Action of State Coalitions in the Advancement of Goals specified in the IOM Report

The recommendations pointed out by the IOM report facilitated the establishment of
strategic goals that optimized the increase in the enrolment of nursing students to 80% and
above. They thus played a significant role in recognition of informed and adequately equipped
caregivers who would address the continually increasing needs of the population across the
nation (The National Academies of Science Engineering Medicine, 2018). These were coupled
with the development of policies based on student operations that focused on the application of
competency in the curriculum used, which enabled continuous improvement and advancement in
educational programs for nursing practitioners. Nonetheless, the achievement of these objectives
necessitated the formulation of state-based action coalitions within different organizations, which
would enhance the application of the recommendation in identifying areas that require
improvement or change.

Most fundamentally, in states such as Arizona, these state-based action coalitions served
as catalysts in the creation of entities that include the Arizonian Board of Nursing. The creation
of such entities and regulatory bodies aimed at ensuring compliance with the increment in the
enrolment of students in the nursing institutions established across the state (The National
Academies of Science Engineering Medicine, 2018). Additionally, they were coupled with
collaborative operations such as licensure, accreditation, and certification of qualified nurses
based on their completion of nursing programs and satisfaction in adhering to the various

Initiatives spearheaded by State-based action Coalitions

Some initiatives such as the Arizona Action Coalition (AZAC) entail some efforts led by
IOM in collaboration with regulatory bodies in a different part of the country. As such, AZAC’s
primary objective involves the adaptation to the eighth recommendation as highlighted in the
IOM report. More precisely, it specializes in improvements in spheres such as nursing research,
the acquisition, and the interpretation of information relevant to the operations carried out by
nursing practitioners (Arizona Chamber of Commerce, 2016). The committee that oversees such
operations plays a significant role in the provision of opportunities that advance nursing
activities by ensuring sustenance in the resources and infrastructure used in collecting, analyzing,
and maintaining information regarding the availability and adequacy of nursing professionals.
Besides, it prioritizes coordination across the state by bringing together committed stakeholders
to work collaboratively in addressing the emergent issues in the nursing profession.

Similarly, in 2016, the Center to Champion Nursing in America (CCNA) initiative, set up
by the AARP Foundation and the RWJF, aimed at convening individuals, groups as well as
organizations in the health sector towards the adoption and application of IOM
recommendations. As a result, it significantly contributed to the development of collaborative
platforms involving entities such as the Arizona State Board of Nursing, the Arizona Nurses
Association, and the Arizona Hospital Healthcare Association to mention a few. Under the
CCNA initiative, the collaboration between these organizations facilitated the engagement of
different parties and individuals in advancing the operations carried out by nursing professionals
(Randolph, 2016). It further promoted nursing practices as a vital element in society that should
be addressed through a coalition in activities carried out by different healthcare entities in

Barriers to the Advancement that exist in Arizona

The advancement of healthcare practices in Arizona is characterized by hindrances that
inhibit the achievement of the recommendations outlined in the IOM report. Crucial among these
hindrances is the inadequacy in sustainable infrastructure as well as a main storage unit or
facility for information related to nursing professionals and other caregivers that is essential in
making decisions or effectively planning (Arizona Chamber of Commerce, 2016). Nevertheless,
nursing advocates within the country contributed to the formulation of two-year plan (RWJF SIP
Grant) that focused on the facilitation of the development of collaborative platforms between the
steering committee and healthcare professionals across the state (Randolph, 2016). It further
brought together the various health organizations and regulatory bodies within the country to
improve nursing practices by addressing the emergent issues in the profession.


Arizona Chamber of Commerce. (2016). Arizona Action Coalition Nursing Workforce
Partner/Stakeholder Kick-Off. Arizona Nurses Foundation, 1-24. Retrieved from

Institute of Medicine. (2018, January 16). The Future of Nursing: Focus on Scope of Practice:
Health and Medicine Division.

The National Academies of Sciences Engineering Medicine. (2018, October 19). Robert Wood
Johnson Foundation Initiative on the Future of Nursing, at the Institute of Medicine:
Health and Medicine Division.

Randolph, P. (2016, November 1). Arizona Action Coalition.