The Future of Nursing 2020-2030 Charting a Path to Achieve Health Equity (2021) / Chapter Skim
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1 Introduction
1 Introduction
Pages 17-30
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From page 17... ...
Because of its impact on health status, achieving health equity is urgent. Achieving this goal will require stakeholders, including nurses and the nursing profession, to focus singular attention on closing the chasm between what is known about equity in health and health care and what can be done to achieve it.
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THE NURSING PROFESSION Nursing is the nation's largest health profession, numbering close to 4 million nurses in 2018 (HRSA, 2021)
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Advanced practice registered nurses (APRNs) hold at least a master's degree in addition to the initial nursing education and licensing required for all RNs, and may continue in clinical practice or prepare for administrative and leadership posi tions.
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The nation is still adapting to the passage of the Patient Protection and Affordable Care Act of 2010, but additional policy changes will come in this decade with the recent passage of the American Rescue Plan Act of 2021.1 Significantly, low- and middle-income individuals and families will receive additional help with their insurance premiums and tax credits and mental health and substance abuse services. Approaches to health care payment are evolving, with fee-for-service payment increasingly giving way to an emphasis on the use of payment to reward providers for achieving better health outcomes.
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Medical care denotes services clinicians provide on a daily basis, such as performing surgeries, checking blood sugar, and titrating blood pressure medications, in settings that include hospitals, surgery centers, and clinics. However, medical care emphasizes disease treatment rather than prevention and rarely addresses SDOH, such as socioeconomic factors and physical environments, that are strong predictors of health outcomes (Hood et al., 2016; Nau et al., 2019)
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By 2030, the nursing profession will look very different than it does today and will need to provide care for a changing America.
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The campaign has helped form state action coalitions -- groups of nurses and other health care providers, employers, patients, students, and others -- in every state to work with health, education, business, and other leaders in promoting better health through nursing to improve health equity and to create communities in which everyone has access to high-quality care. The campaign's focus has been on implementing the recommendations of the 2011 The Future of Nursing report, as well as inspiring and specifying strategies for involving nurses in addressing SDOH and health equity.
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BOX 1-2 Statement of Task An ad hoc committee under the auspices of the National Academies of Sci ences, Engineering, and Medicine will produce a consensus report that will chart a path for the nursing profession to help our nation create a Culture of Health, reduce health disparities, and improve the health and well-being of the U.S. pop ulation in the 21st century.
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STUDY APPROACH To conduct this study, the National Academies assembled a committee of 15 experts in the fields of nursing leadership, education, practice, and workforce; some members have backgrounds in health policy, economics and health care finance, informatics,2 population health and health disparities, health care quality and delivery, and health care research and interventions. Biographical sketches of the committee members and study staff are provided in Appendix A
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. The committee interpreted the concept of a culture of health as essentially denoting health equity, and therefore considered health equity to be its primary focus as it considered the evolving roles of nurses and the nursing profession in helping to improve population health.
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Nurses play multiple roles in acute, community, and public health settings that include, but are not limited to, care team member and leader, primary care provider, patient and family advocate, population health coordina NURSE'S ROLE IN ADDRESSING HEALTH EQUITY AND HEALTH CARE EQUITY KEY AREAS FOR STRENGTHENING NURSING Workforce | Leadership | Education | Well-being | Emergency Preparedness/Response NURSING ROLES* PAYMENT, LAWS, POLICIES, DETERMINANTS OF HEALTH AND Medical Structural REGULATIONS and Social Individual HEALTH EQUITY AND HEALTH CARE EQUITY Improved Individual and Population Health EVOLVING TRENDS Demographics | Technology | Care Models | Public Health Emergencies | Attitudes Toward Racism and Equity *
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Chapter 7 explores the changes in education needed to prepare and engage the nursing profession to address disparities and contribute to achieving equity in health and health care, and Chapter 8 describes the role of nurses in disaster preparedness and public health emergency response. Chapters 9 and 10, respectively, examine nursing leadership, with a focus on ensuring that nurses are leading and engaging across sectors and teams, and the importance of supporting nurses' well-being as they take on new roles and challenges to meet evolving needs.
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APRN (Advanced Practice Registered Nurse) Joint Dialogue Group.
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2018. The hospice and palliative care advanced practice registered nurse workforce: Results of a national survey.
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