The Future of Nursing Leading Change, Advancing Health (2011) / Chapter Skim
Currently Skimming:
1 Key Messages of the Report
1 Key Messages of the Report
Pages 21-46
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From page 21... ...
This chapter presents the key messages that emerged from the study committee's deliberations. It begins by describing a vision for a transformed system that can meet the health 21
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From page 22... ...
Systemwide changes are needed that capture the full economic value of nurses and take into account the growing body of evidence that links nursing practice to improvements in the safety and quality of care. Advanced practice registered nurses (APRNs)
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APRNs include nurse practitioners, clinical nurse specialists, certified registered nurse anesthetists, and certified nurse midwives (see Table 1-1)
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Likewise, while changes in the health care system will have profound effects on all providers, this will be undoubtedly true for nurses. Traditional nursing competencies such as care management and coordination, patient education, public health intervention, and transitional care are likely to dominate in a reformed health care system as it inevitably moves toward an emphasis on prevention and management rather than acute care (O'Neil, 2009)
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. Many members of the profession lack the education and preparation necessary to adapt to new roles quickly in response to rapidly changing health care settings and an evolving health care sys
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Provide advanced nursing care in hospitals and other clinical Specialists sites; provide acute and chronic care management; develop (CNSs) quality improvement programs; serve as mentors, educators, researchers, and consultants.
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This database, which meets the new reporting requirement by the Centers for Medicare and Medicaid Services for nursing-sensitive care, is supported by the American Nurses Association.2 More than 25 percent of hospitals participate in the database, which documents more than 21 measures of hospital performance linked to the availability and quality of nursing services in acute care settings. Participating facilities are able to obtain unit-level comparative data, including patient and staffing outcomes, to use for quality improvement purposes.
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From page 28... ...
However, the evidence base in favor of such a conclusion is growing. Compared with other models of prenatal care, for example, pregnant women who receive care led by certified nurse midwives are less likely to experience antenatal hospitalization, and their babies are more likely to have a shorter hospital stay (Hatem et al., 2008)
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From page 29... ...
Removing regulatory, policy, and financial barriers to promote patient choice and patient-centered care should be foundational in the building of a reformed health care system. Additionally, to the extent that the nursing profession envisions its future as confined to acute care settings, such as inpatient hospitals, its ability to help shape the future U.S.
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In general, less than 20 percent of nursing practice time was devoted specifically to patient care activities, the majority being consumed by documentation, medication administration, and communication regarding the patient (Hendrich et al., 2008)
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From page 31... ...
The system should ensure nurses' ability to adapt and be flexible in response to changes in science, technology, and population demographics that shape the delivery of care. Nursing education at all levels needs to impart a better understanding of ways to work in the context of and lead change within health care delivery systems, methods for quality improvement and system redesign, methods for designing effective care delivery models and reducing patient risk, and care management and other roles involving expanded authority and responsibility.
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From page 32... ...
Nurses should move seamlessly through the education system to higher levels of education, including graduate degrees. Nurses with graduate degrees will be able to replenish the nurse faculty pool; advance nursing science and contribute to the knowledge base on how nurses can provide up-to-date, safe patient care; participate in health care decisions; and provide the leadership needed to establish nurses as full partners in health care redesign efforts (see the section on leadership below)
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From page 33... ...
The Need for Better Data on the Health Care Workforce Key Message #4: Effective workforce planning and policy making require better data collection and an improved in formation infrastructure. Key messages 1, 2, and 3 speak to the need to transform the nursing profession to achieve the vision of health care set forth at the beginning of this chapter.
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From page 34... ...
nurses should be full partners, with physicians and other health professionals, in redesigning health care in the United States; and (4) effective workforce planning and policy making require better data collection and an improved information infrastructure.
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2010. The registered nurse population: Find ings from the 200 National Sample Survey of Registered Nurses.
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2010. Federal options for maximizing the value of advanced practice nurses in providing quality, cost-effective health care.
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The committee considers the full range of services to be encompassed by the term "health care," including prevention and health promotion, mental and behavioral health, and primary care services; public health; acute care; chronic disease management; transitional care; long-term care; palliative care; end-of-life care; and other specialty health care services.
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From page 38... ...
PREPARATION AND ROLES OF NURSING CARE PROVIDERS IN AMERICA The range of nursing care providers described below work in a variety of settings including ambulatory care, hospitals, community health centers, public health agencies, long-term care facilities, mental health facilities, war zones, prisons, and schools of nursing, as well as patients' homes, schools, places of worship, and workplaces. Basically anywhere there are health care needs, nurses can usually be found.
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From page 39... ...
Many RNs practice in medical-surgical areas; some other common specialties among registered nurses, many of which offer specialty certification options, include: Critical Care Nurses provide care to patients with serious, complex, and acute illnesses or injuries that require very close monitoring and extensive medication protocols and therapies. Critical care nurses most often work in intensive care units of hospitals; however, nurses also provide highly acute and complex care in emergency rooms.
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From page 40... ...
There are several entry points as well as progression points for registered nurses: Associate Degree in Nursing (ADN) or Diploma in Nursing prepared RNs provide direct patient care in various health care settings.
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From page 41... ...
APRNs fall into four broad categories: Nurse Practi tioner, Clinical Nurse Specialist, Nurse Anesthetist, and Nurse Midwife: Nurse Practitioners (NPs) are Advanced Practice RNs who provide a wide range of healthcare services across healthcare settings.
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Doctoral Degrees in Nursing include the Doctor of Philosophy in Nursing (PhD) 4 and the Doctor of Nursing Practice (DNP)
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nursing leadership, and $66,316 translating research into nursing practice across all health care settings. Associate 2 to 3 years Provide direct patient ADN mean salary Degree (ADN)
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BSN or MSN to nursing doctorate options available. Masters Degree in Prepares Advanced Practice Registered Nurses (APRNs)
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From page 45... ...
2010c. Providers of nursing care: Numbers, preparation/training and roles: A fact sheet.
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Key Terms
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