Implementation of the IOM Future

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Implementationof the IOM Future of Nursing Report

TheFuture of Nursing: Leading Change, Advancing Health

In2010, Robert Wood Johnson Foundation and the Institute of Medicine(IOM) jointly released a research report &quotThe Future of Nursing:Leading Change, Advancing Health.&quot This report served as ablueprint to be used to transform the US health system throughstrengthening the nursing care and preparation of the nurses tospearhead the reforms. The report recommended an increase in thenumberof nurses holding bachelor’s degree in nursing and above. For thisto be successful,it will require several changes in the healthcare sector such asseamless educational progression, new competency-based curricula,educational capacity building, extra funding to accelerate setprograms, student diversity,and better employer incentives to accelerate progression.The nursing sub-sector is the largest in the health care workforce inthe state. Nurses can help in the realizationof the set objectives in the IOM report of 2010 for providing qualityand affordable care to patients. Severalbarriers preventnurses from responding effectively and efficiently to rapid changesin the health care system as it evolves (Iglehart, 2013).Thehealthcarestakeholders need to ensure that all the barriersare dealt with so as to position the nurses well to advance healthand lead change. After the committee had evaluatedthe American health care system, they came up with four key messages:

  1. Nurses are supposed to practice to their level best based on the education and training they have received.

  2. The education system should be improved so that it promotes seamless academic progression, and nurses can acquire a higher education and training level.

  3. In redesigning the United States health system, nurses need to be partners with all professionals of health care.

  4. Efficient making of policy and planning of workforce needs an advanced infrastructure of information and data gathering.

Theimportance of IOM report

Themain aim of the report is to change the system of healthcare so as toprovide quality, accessible, patient-centered,safe and affordable care. Thus, in the realization of the setobjectives, nurses’ education needs to be improved before, andafter they have received their licenses. The report identifiedseveral challenges and offered some solutions to these challenges.The report recommended that nurses should receive more training andhigher education. The educationsystem should promote seamless academic progression for the nurses(Nardi, &amp Gyurko, 2013).

Nursesneed more training

Thechallenges facing the health care systems in the 21stcentury are shifting dramatically in the California State and otherpartsof the world. In the United States, people with 65 years and abovewill account for20 percent of the whole population by 2030. Due to such changes, thehealth care is also shifting and becoming more complex.Also, there are more chronic illness cases in the nation such ashypertension, diabetes, cardiovascular diseases among others due toincreased aging population and obesity levels (Kaspar, &amp Vessey,2011). Thus, the way nurses were educated in the 20thcentury is not adequate to deal with health realities in the 21stcentury. Nurses need to acquire higher education for them to deliverquality care to the patients effectively. Health providers need toensure there are goodleadership, system improvements, health policy, collaboration andteamwork among health professionals. Thus, the IOM committeerecommended that nurses should receive higher education.

CaliforniaAction Coalition

CaliforniaAction Coalition is the state-based coalition that is involved in theadvancement of The Future of Nursing goals. The action coalitionspearheads education and leadership initiatives in healthcare withinthe state of California.


TheIOM report found out that nursing workforce requires expansion tomeet the growing health needs. It emphasized that nurses shouldrealize the value in establishing their knowledge, and the system ofeducation should allow and encourage them to do so on a regularbasis. Since the bachelor`s degree is the primary catalyst to highergrowth in knowledge in the profession, the California ActionCoalition encourages nurses to begin their careers with a degree. Forthe nurses in possession of an associate degree, the reportrecommended&nbspandestablished five models which can help nurses attain higher educationlevels by earning a bachelor`s degree either while obtaining anassociate degree or after. Higher education increases the nurses’abilities to manage the complexity of advanced technology and patientcare by giving them the chance to make decisive contributions to ateam of health care, understanding the policy of health, or analyzingdata to make important decisions. California Action Coalition’s&nbspaimis to increase the percentage of the nurses with baccalaureatedegrees to 80% by 2020 and to double the nurses with doctoratedegrees. In the past two years, the coalition’s efforts have seenthe number of nurses with bachelor’s degrees rise by 8.3%% to61.5%. This improvement in the higher education of nurses will helpin ensuring that California produces the best nurses to serve thenation (Kaspar, &amp Vessey, 2011).


Thecoalition is spearheading the preparation of nurses to enable them tolead change and advancement in the healthcare system. There is aleadership workgroup that creates leadership competencies, organizesseminars on the web, and inspires the next generation leaders in thenursing profession. 217 mentors and mentee pairs have gone throughthe LifeMoxie leadership program offered by California ActionCoalition.

Barriersto advancement

Inthe state of California, there are challenges that hinder thedevelopment of the health sector as well as implementing all therecommendations of the IOM report. These barriers impact the mainelements of a developed health sector as mentioned in the report.They include insufficient funding and inadequate health workforce(Nardi, &amp Gyurko, 2013).

Fundsare very important when it comes to health sector as it helps in thepurchase of advanced equipment in the state, maintenance of theequipment, sourcing of medicine and other medical facilities.California is a state with a relatively high population, and thisimplies that there should be enough funds allocated to run the healthsector, but here is where the problem lies. Most public healthfacilities are faced with the challenge of inadequate funding, andthis contributes to problems like poor medication, poor and outdatedequipment and inadequate medical facilities that translate to thewrong diagnosis. It also results in the lack of access to medicalservices, and this mostly affects the low-income earners (Nardi, &ampGyurko, 2013).

Theother barrier to advancement in the healthcare sector in Californiais insufficient staff to serve in the public health facilities. Thiscan be attributed to the high cost of training nurses and doctors inCalifornia considering the financial instability. Since there is achallenge of insufficient funding, the public hospitals are not ableto hire the most qualified nurses and doctors, unlike the privatehospitals. This increases cases of overcrowding in hospital wards andto some extent poor services to the low-income families in California(Kaspar, &amp Vessey, 2011).

Approachesfor overcoming the barriers

Thenursing advocates can help to overcome the barrier of insufficientfunds in this sector by advocating for more funds from the state andfederal governments to be allocated towards the development ofhealthcare services. Apart from that, the advocates can look forsponsors to help improve the financial situation of the state ofCalifornia. Additional funds can help in improving the facilities andbuying equipment, sourcing for medicine among other healthrequirements (Iglehart, 2013).If more nurses are trained and wellpaid, then the advocates can help overcome the problem of theinadequate workforce in this state. In addition to this, the salariescan be increased to prevent the trained nurses from preferring towork in private health facilities.


Iglehart,J. K. (2013). Expandingthe role of advanced nurse practitioners—risks and rewards.&nbspNewEngland Journal of Medicine,&nbsp368(20),1935-1941.

Kaspar,C., Debisette, A. &amp Vessey, J. (2011).&nbspAnnualreview of nursing research : nursing workforce issues. Volume 28,2010.New York, N.Y: Springer Pub. C

Nardi,D. A., &amp Gyurko, C. C. (2013). Theglobal nursing faculty shortage: Status and solutions forchange.&nbspJournalof Nursing Scholarship,&nbsp45(3),317-326.

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