The Institute of Medicine (IOM) developed recommendations in 2001 for the delivery of patient-centered care. The vision set forth by the IOM uses the principle of educating all health care professionals as an interdisciplinary team emphasizing evidenced-based practice, quality improvement approaches and informatics. According to the IOM committee, a competency based approach could result in better quality care because educators would have information on the outcomes. This would lead to better patient care. In today’s health care market, better patient care will result in higher patient satisfaction scores. In turn, reimbursements will be higher.
The Institute of Medicine released an evaluation on its 2010 landmark “The Future of Nursing:
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Leading Change, Advancing Health" report. The report made a series of recommendations pertaining to the roles for nurses in the 2010 healthcare industry, whereas the 2001 report focused on all health care professions. With the narrowing of their scope to nursing, the field has a high bar set as far as goals that need to be met. Recommendation #1 - Removal of Scope of Practice Barriers The recommendation suggests advanced practice registered nurses should be able to practice to the full extent of their education and training. The Medicare program would be revamped include coverage of advanced practice registered nurse services that are within the scope of practice under applicable state law, just as physician services are now covered. Advanced practice registered nurses would perform admission assessments, as well as certification of patients for home health care services and for admission to hospice and skilled nursing facilities. If met, this recommendation would be huge in the advancement of autonomy for nurses. This would be a very positive contribution to the patient-centered care model. Recommendation #2 - Continue pathways increasing the percentage of nurses with a BSN and/or advanced degree Institutions should provide nurses opportunities to seek and obtain a BSN or advanced degree. Transition to these programs should be smooth and effortless. Financial incentives should be provided for nurses on this track, whether in form of tuition reimbursement or some level of assistance. Upon receipt of the degree, an increase in salary would prove advantageous for the nurse. This recommendation is another positive in the field of nursing. The field of nursing is in a constant state of change. Nurses that pursue a higher level of education should be compensated. Recommendation #3 – Implementation of nurse residency program State boards of nursing, accrediting bodies, the federal government, and health care organizations should take actions to support nurses’ completion of a transition-to-practice program (nurse residency) after they have completed a pre-licensure or advanced practice degree program or when they are transitioning into new clinical practice areas (Gooch, 2015). These efforts should include determining the most appropriate program models; setting standards for programs; exploring funding and business case models; and creating an overarching structure from which to track and evaluate the quality, effectiveness and impact of transition-to-practice programs (The Future, 2010). The transition from new graduate to Again, this is a recommendation that is empowering nurses to be the best they can be with the patient-centered care model in mind. Recommendation #4 – Support the pursuit of Doctoral degrees The committee emphasized the importance of promoting nurses' pursuit of both the doctor of nursing practice and doctor of philosophy degree, through incentives and expansion of programs. This initiative would ensure healthcare has an adequate supply of nurses for clinical care, research, faculty and leadership positions. "More emphasis should be placed on increasing the number of PhD nurses in particular," committee members wrote in their report. "To maximize the potential value of their additional education, nurses should be encouraged to pursue these degrees early in their careers. PhD and DNP programs should offer coursework that prepares students to serve as faculty, including preparing them to teach in an evolving healthcare system (The Future, 2010). With the impending nursing shortage, faculty will be paramount in preparation of student nurses. While a Master’s prepared nurse may teach, the Doctoral prepared nurse can serve as an additional resource and mentor for the young nurse. Recommendation #5 - Ensure the engagement of lifelong learning Accrediting bodies, schools of nursing, health care organizations, and continuing competency educators from multiple health professions should collaborate to ensure that nurses and nursing students and faculty continue their education and engage in lifelong learning to gain the competencies needed to provide care for diverse populations across the lifespan (The Future, 2010).
Faculty should partner with health care organizations to develop and prioritize competencies so curricula can be updated regularly to ensure that graduates at all levels are prepared to meet the current and future health needs of the population. Academic administrators should require all faculty to participate in continuing professional development and to perform with the utmost competence in practice, teaching, and research. Health care organizations offering continuing competency programs should regularly evaluate their programs for impact on clinical outcomes and update the programs accordingly to meet the changing needs of the population. In the changing dynamics of healthcare, this recommendation will have an unquestionable impact on patient care. As new skills are learned and tested, the lifelong learner will have the capacity to provide cutting-edge care to …show more content…
patients. Recommendation #6 - Prepare and enable nurses to lead change to advance health. Nurses, nursing education programs, and nursing associations should prepare the nursing workforce to assume leadership positions across all levels: public, private, and governmental. Health care decision makers should ensure leadership positions are available to and filled by nurses (The Future, 2010). It is the nurses’ responsibility for their personal and professional growth. By continuing their education and seeking opportunities to develop their leadership skills, they reinforce their commitment to their patients. Institutions should provide leadership development, mentoring programs, and opportunities to lead for all their members. To have a positive impact in health care, leadership roles need to be obtained and held my members of the nursing community. Their representation in the health care industry is paramount for advancing health. Recommendation #7 - Promote diversity in the workforce as a priority The diversity of cultures in the United States should be represented by the nursing workforce caring for those populations.
The importance of promoting diversity in the nursing workforce is acknowledged by various nursing agencies and health organizations, including the American Association of Colleges of Nursing (AACN, 2013). Diversity in the nursing workforce provides opportunities to deliver quality care which promotes patient satisfaction and emotional well-being. Reaching across the boundaries of culture is very important in delivering patient-centered care. Nurses are to be trusted by their patients. If a diverse population is not met with a diverse workforce, that trust may not be gained. This recommendation promotes the bonding of individuals based on culture and
beliefs. Recommendation #8 – Communicate with a wider and more diverse audience to gain broad support for campaign objectives. The promotion of communication driven by nurses to connect with a broader, more diverse, consumer-oriented audience and spur grassroots support reflects the power that is held by this profession (The Future, 2010). Nurses make up the largest segment of the health care profession; there are approximately 3 million registered nurses in the United States. This voice on the campaign trail can be influential when lobbying for a cause. Nurses have the patient’s best interest in mind. With 3 million potential voices, it can become loud if the voices are proactive in supporting a cause. Recommendation #9 – Promote the involvement of nurses in the redesign of care delivery and payment systems. Nurses are encouraged to work with payers, healthcare organizations, providers, employers and regulators in the redesign of care delivery and payment systems. It was suggested doing this by encouraging nurses to serve in executive and leadership positions in government, for-profit and nonprofit organizations, and healthcare delivery systems (e.g., as hospital CEOs or COOs), and advisory committees (The Future, 2010). Recommendation #10 – Improve data collection The campaign should emphasize improving workforce data collection and in that focus on the need for collaboration in terms of analysis and collection of workforce data. The campaign can use its strong brand and partnerships to help improve the collection of data on the nursing workforce. Following these recommendations is only part of the solution. Collecting, analyzing and researching the data is the other part. Having the tools in place to do this in the form of informatics will ensure the data is used properly. Nurses are already committed to delivering high-quality care under current regulations. The power to change those conditions to deliver better care does not rest primarily with nurses. Although it is a good start, the government and organizational leaders need to be on board with the recommendations. We will always be in pursuit of excellence as nurses. Without the support of the appropriate powers, the pursuit will be in circles instead of reaching the goals set forth.
Bednarz, Hedi, MSN,A.C.N.S.-B.C., C.N.E., Schim, Stephanie, PhD,R.N., P.H.C.N.S.-B.C., & Doorenbos, Ardith,PhD., R.N. (2010). Cultural diversity in nursing education: Perils, pitfalls, and pearls. Journal of Nursing Education, 49(5), 253-60. doi:http://dx.doi.org/10.3928/01484834-20100115-02
IOM (Institute of Medicine). (2011). The future of nursing: leading change, advancing health. Washington, DC: The National Academies Press.
Institute of Medicine (2010). The future of nursing: Leading change advancing health Retrieved from http://books.nap.edu/openbook.php?record_id=12956&page+R1
Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the Institute of Medicine Testimony Submitted by The Joint Commission, Cong. 1 (2010) (testimony of ).
This essay will focus on outlining the fundamental principles of cultural diversity and how effective nursing interventions are used when providing an adequate amount of care for an individual from a culturally diverse background and how this may collide with the nursing therapeutic engagement. This essay will give the reader an insight upon culture whilst giving a significant explanation of cultural differences within a health setting. The patient’s real name will not be used and will be referred to as Mr. X. This is in line with the Nursing and midwifery Council 2008 (NMC, 2008) requirements to maintain confidentiality at all times.
Baccalaureate-prepared nurses should demonstrate cultural awareness and competence in their practice in order to provide quality care to diverse populations in the society (Kersey-Matusiak, 2012). The US health care system faces disparities in the health status of different cultural groups such as the racial and ethnic minorities, the economically disadvantaged groups and rural populations (Jeffreys, 2006). Cultural competence refers to the attitudes, knowledge, and skills that are necessary for providing care in diverse populations and I believe that I have acquired personal cultural awareness and competence (Weber & Kelly, 2009). I am able to promote social justice by remaining impartial
Integrating the framework will enable nurses to become culturally competent health care providers. First and foremost, the framework permit patients’ the opportunity to express their concerns and perception of their problem (Campinha-Bacote, 2011). Additionally, it focuses on incorporating the patients beliefs, values, and needs into the plan of care. The framework further give nurses an opportunity to better understand and evaluate their patients’ concerns. Campinha-Bacote (2011) reported that continuous encounters with culturally diverse backgrounds will lead nurses to validate, refine, or modify what they know of existing values, beliefs, and practices of a cultural group. This in turn, will develop into cultural desire, cultural awareness, and cultural knowledge. With the end result, being cultural
Cultural competence has a variety of definitions and, in health care, basically refers to the act of developing an awareness of yourself, your existence, your thoughts, and your environment and making sure that those elements do not unjustly affect the clients you serve (Giger, 2013). In this paper, I will share my total score and what I learned about myself after taking the Cultural Diversity Self Assessment (IllinoisCTE, n.d.), discuss two weaknesses or areas with lower scores, and review two strengths with higher scores. I will reflect on my findings and examine the impact that my strengths and weaknesses may have on my nursing care. In addition, I will discuss improving cultural competence and two strategies
Over the last several weeks we have learned that we live in a culturally diverse world. We have learned that it is important to acknowledge our own cultural values and beliefs while also realizing that others around us have their own beliefs. In order to provide culturally sensitive care, we must also realize the meaning of diversity and how it can also relate to the health care workforce. The purpose of this post is to define what diversity means to me. I will describe what some of the benefits of having a diverse health care workforce is while acknowledging that this could also provide some barriers in the nursing profession. I will conclude by considering my own diverse cultural background and experiences and how it might relate to the
According to the Society for Human Resource Management diversity is: “A broad definition of diversity ranges from personality and work style to all of the visible dimensions of diversity such as race, age, ethnicity or gender, to secondary influences such as religion, socioeconomics and education, to work diversities such as management and union, functional level and classification or proximity/distance to headquarters.” Diversity is a huge factor that we are striving for in many occupations around the world, but healthcare is one of the main professions that is becoming more diverse. Not only does it have many positive effects, it is providing the patients and workers with a sense of respect for each other. The patients are able to have a nurse or occupational therapists that understand where they are coming from. They might have the same morals or they might be in a similar situation as the patient, so they will be able to relate with the patient and understand them during difficult times. More companies are relating diversity into the workforce. Therefore they are able to have a more successful business because of the many changes they are making to meet the needs of each individual.
The Institute of Medicine has released a report that discusses the future in nursing. The IOM has developed four key messages that outline the barriers that need to be overcome, so that nurses can work effectively and to their fullest ability.
As a nurse strive to provide culturally sensitive care, they must recognize how their client's and their perceptions are similiar as well as different. Nurse enhance their ability to provide client-centered care by reflecting on how their beliefs and values impact the nurse-patient relationship. To provide appropriate patient care, the nurse must understand her/his culture and that of the nurse profession. Cultural biases can be particularly difficult to identify when the nurse and client are of a similar cultural backgroup. When we recognize and know a culture, we will know what is right for our patient, and thus may impose our own values on the client by assuming our values are their values. Recognizing differences a present an opportunity not only to know the other, but also to help gain a greater sense of self. In this paper, I will explain more about diversity and cultural competence in case study.
Characteristics can be as diverse as ethnic background, language spoken, gender status, physical appearance, race, and religion to name a few. Migration from various countries is creating a diverse population with different cultures and languages within the United States. Due to these cultural differences and lack of knowledge, disparities are increasing. Studies have shown that both language barriers and lack of cultural customs can hinder the services provided to the patient by the healthcare worker (Renzaho, Romios, Crock, & Sonderlund, 2013). This study provided a positive outcome when communication and cultural mutual understanding took place and patients had a more positive health outcome. It is very important that nurses are diversified in various cultures in order to better care for our patients. According to Mareno and Hart (2014), cultural competency has become one of the core values being taught in nursing programs. Their study showed that the perceived level of cultural awareness and skills among the nurses provided was low. Awareness and knowledge levels increased with higher education. It was highly recommended that self-awareness exercises be incorporated into the nursing course and continued to be addressed during the remaining curriculum until
Several years ago in 2008 the RWJF and the IOM collaborated for two years to discern the future needs of the nursing profession. Most importantly, the objective was to outline the critical actions needed to ensure nursing was ready to seamlessly move towards the future. This was no easy task as nurses work in such diverse settings such as outpatient areas, acute care settings, the community, and long term settings to name a few. Couple this with the fact that nurses have a variety of educational avenues such as the associates, diploma, or bachelor’s degree open to them to achieve the status of registered nurse (Institute of Medicine, 2010). All of this considered, the committee did design four key messages regarding the future of nursing as key in the transformation of health care as evidenced in their "Future of Nursing" report.
for nurses to be aware of the diverse needs of many differing cultures. Learning and