...011), Advanced Practice Registered Nurses (APRNs) have been authorized to prescribe non-scheduled legend drugs and controlled substances to their patients after acquiring a written collaborative agreement with a physician licensed in Kentucky (KBN, 2018). The author of this paper resides in the state of Kentucky. The proposed Senate bill addressed in this paper amends the current practice of prescriptive authorities for APRNs in that state. The Bill proposes an expansion of the APRNs role in prescribing medication. Proposed Benefit SB 89(BR-1094) was introduced in the Senate on Wednesday, January 17, 2018. The Bill was sponsored by Senator Paul Hornback, from Senate district 20. The Bill...
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...created to establish doctorate prepared practitioners (DNP Fact Sheet, 2015). A DNP is a terminal degree with a practice focus instead of a PhD which is research focused (Position Statement, 2004). The American Association of Colleges of Nursing (AACN) believe that the advanced practice nurse (APRN) should be educated at the doctoral level due to the “changing demands of the nation’s complex healthcare environment” (Fact Sheet). The AACN believes there are many factors that are pushing nursing to doctoral prepared practitioners, some examples are rapid expansion of knowledge, complexity of care, quality of care and patient safety, nursing shortages (bedside and faculty), and increasing education expectation from other...
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...acts to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education” (Institute of Medicine [IOM], 2010, p. 5) In October 2010, The IOM (Institute of Medicine) released the report, The Future of Nursing: Leading Change, Advancing Health. This report examines the changing roles of nursing in healthcare, changes in nursing education and the changing roles as nurses as leaders This report was the culmination of two years of research by the Robert Wood Johnson Foundation (RWJF) and focused on best nursing practices in the United States, as well as, anticipated changes in healthcare and the implication it will have on nursing. With changes in healthcare such as the Affordable Care Act of 2010 (ACA), nurses will be playing an ever increasing role in patient centered care as healthcare moves away from acute and specialty care, and focuses more on primary care. Today the top providers of primary care are physicians (287,000), nurse practitioners (83,000), and physician assistants (23,000) (Steinwald, 2008; HRSA, 2008). The demand for advanced practice registered nurses (APRN) is expected to increase dramatically to accommodate patients seeking primary care. The IOM suggests that to prepare for this increased demand for nurse practitioners “all health care professionals should practice to the full extent of their education and training so that more patients may benefit” (IOM, 2010, p. 96). This would include standardizing...
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...and optimal well-being. Praxis is different from one nurse to another. Nurse expertize develops overtime, through ongoing knowledge, critical thinking skills, and how one perceive the situation. Experience encourages self-motivation and promotes change (Chinn & Kramer, 2011). APN’s encounter with each patient is different, unique, and requires self-reflection of the encounter. With the current changes in patient care needs, praxis should be geared towards the APN area of practice (Masters, 2011).The more individualized the praxis framework the higher the wanted outcome, for both the practitioner and the patient. It is critical for an APN to have a picture of the expected role in practice. Overview of Advanced Nursing Role The family nurse practitioner (FNP) is an advanced practice registered nurse (APRN), who cares for patients and families across the lifespan. The...
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...Professional Development of Nursing Professionals Professional Development of Nursing Professionals Erica L. Carroll Grand Canyon University: NRS-430V Professional Dynamics December 13, 2015 Professional Development of Nursing Professionals The 2010 Institute of Medicine (IOM) report “The Future of Nursing: Leading Change, Advancing Health” asks “What roles can nursing assume to address the increasing demand for safe, high-quality, and effective health care services?” (IOM, 2010, p. xi, par 2). This paper will address three major categories that are impacted by the IOM report: education, practice, and leadership. Impact on Nursing Education According to the IOM report nursing education should include change management, quality improvement, and care management, as well as stressing the importance of lifelong learning and continuing education (IOM, 2010). To this end, the IOM is in favor of an all Bachelors of Science in Nursing (BSN) work force (IOM, 2010). The IOM isn’t alone, one survey showed 76% of physicians surveyed felt BSNs were more competent that Associate Degree in Nursing (ADN) (Institute of Medicine, 2010, p. 171, par 1). The American Association of Colleges of Nursing (AACN) also supports the need for BSN trained nurses. They state the BSN trained nurse is better-rounded, has more advanced critical thinking skills, and are more ready to step into an entry level leadership role than their ADN counterparts (AACN, 2012). One study shows hospitals would...
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...Title: Development of the Future of Nursing James Flynn Grand Canyon University December 7, 2012 Title: Development of the Future of Nursing In an effort to provide American citizens with high quality, affordable health care the president signed into law and passed with help of congress, the Patient Protection and Affordable Care Act also known as the Affordable Care Act (ACA) in March of 2010. The ACA will attempt to provide at least 94% of the population with quality health coverage, while staying within the means of the average citizen. At the same time staying within the $900,000,000.00 budget set by President Barak Obama (Responsible Reform for the Middle Class n.d.). This however, will not be an easy task. In 2010 The Robert Wood Johnson Foundation (RWJF) alongside with the Institute of Medicine (IOM) released the report “Future of Nursing: Leading Change, Advancing Health” (Committee on the Robert Wood Johnson Foundation 2011). At its core the report was a mandate to renovate the current health care system, and at the same time introducing nursing as an essential piece to this renovation. Within the IOM’s report are a few key points that outline their vision of the future of heath care (2011). If instituted, these key points will have major and long term affects on the nursing profession. The report places a higher responsibility on the Advanced Practice Registered Nurse (APRN) to take on the role of a Primary Care Provider (PCP). In order to accomplish this goal...
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...Professional Development of Nursing Professionals Vann Joyner , RN Grand canyon University NRS430V Professional Dynamics As the delivery of health care system goes through changes to meet the populations demand to provide affordable health care based on the( 2010 Affordable Health Care Act), and as new technology and methods of treatment are introduced to an aging system of old. The way nurses practice will directly need to change how it provides quality patient care. So with nurses being the largest component of the health care system, the role nurses play on the frontline and behind the scenes will need to change. In 2008 The Robert wood Johnson Foundation and the Institute of Medicine (IOM) did a report entitled the “Future of Nursing: Leading Change, Advancing Health”. Within this report recommendations are made to describe the areas in nursing where change is needed to allow nursing to provide optimum nursing care. Three of the areas discussed are how primary care is given by nurses, the need for ongoing nursing education and the development of nursing leaders participating in all areas of the development of health services. Nurses are one the most visible heath care providers you encounter when you think of within the acute care setting, hospitals , urgent care centers , etc. Related to primary care, nurses play a role from admission to discharge. The IOM states that “Nurses should practice to the full extent of their education and training (IOM, 2010).A large...
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...Running head: PROFESSIONAL DEVELOPMENT OF NURSING PROFESSIONALS Professional Development of Nursing Professionals APA 5th edition format Professional Development of Nursing Professionals This paper will explore the impact on nursing of the 2010 Institute of Medicine (IOM) report titled: “The Future of Nursing: Leading Change, Advancing Health”. In this paper I will focus on the impact of the IOM report in the areas of nursing education, nursing practice, and nursing leadership. I will also attempt to explain how I might change my current nursing practice to meet the goals of the report. The Institute of Medicine was established in 1970 and is the health arm of the National Academy of Sciences. It functions as an advisory board, both independent and nonprofit, that works outside government to provide information and offer valid and impartial recommendations to decision makers and to the public. (National Academy of Sciences, 2012). The IOM report makes eight recommendations that stem from four key concepts to address needed changes in the profession of nursing, specifically in regards to meeting the objectives of the 2010 Affordable Care Act. Half of the eight recommendations in the IOM report involve nursing education. It is no surprise that the topic of nursing’s multiple entry-level educational pathways is identified as an area needing restructure. The report specifically recommends an increase from 50% to 80% of baccalaureate prepared nurses by the...
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...facing the nation has significantly changed in the21st century. In the present century nurses with more skills, expertise, and knowledge is required to keep up with changing health care. These changes helped the nurses to expand their knowledge and search various opportunities in all aspects of health care. There are some obstacles, which prevent nurses from responding effectively to a quickly shifting healthcare settings and developing health care system. In 2008, a two- year project to identify and resolve the problems facing the health profession developed by The Robert Wood Johnson Foundation (RWJF) and the Institute of Medicine (IOM). This passage will explain the effect of IOM report on nursing education, practice, and nurse’s role as a leader. The IOM report -The Future of Nursing Leading Change, Advancing Health released in Oct 2010. The IOM selected the Com¬mittee on the RWJF to plan on the expectations of Nursing, with the rationale of developing a report and that would make suggestions for an advanced future of nursing. According to this report, there are so many challenge that facing the education in nursing and some resolutions that will be essential to progress the structure. In this present century, the patient’s requirements and health care settings became more multifaceted, the nurses needed to require competencies to convey expert nursing care. To meet this rising difficulty, the IOM committee recommended that nurses should accomplish top levels of...
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...THE IOM REPORT’S EFFECTS ON NURSING BY TA 11/24/13 The Institute of Medicine (IOM) report focuses on “Transforming Practice, Transforming Education, and Transforming Leadership” in which the goal of a transformed health care system is to provide higher-quality health care centered on the patient and their unique needs, to reduce errors, and increase safety (IOM, 2010, 87). The IOM report states “Nurses have the opportunity to play a central role in transforming the healthcare system to create a more accessible, high-quality, and value-driven environment for patients” (IOM, 2010, 85). In order to work towards this goal, the IOM places a major emphasis on education, the importance of collaboration with physicians and other health professions, and the importance of leadership in nursing practice to make the changes to allow for improvements. This paper will address the IOM’s impact on nursing education, the impact on nursing practice, and the impact on the nurse’s role as leaders to in order to transform the healthcare system. Nursing is a dynamic profession requiring lifelong learning to meet the needs of America’s complex health care system. To ensure safety and quality care, the IOM report places emphasis that the nurse is responsible to stay current on knowledge and practice in order to meet the ever-changing needs of patients. The report states that there is a dramatic shift in demographics, as we face an older and diverse American population with respects to race...
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...Stewart, J.G. & Denisco, S. M. (2015). Role development for the nurse practitioner, (Chapters 6, 9, 10 & 11), Burlington, MA: Jones & Bartlett Learning, LLC. Texas Legislative Council. (2013). Section 1: The Texas legislative Process. In Guide to Texas Legislative Information, pp 1 - 10. Retrieved from http://www.tlc.state.tx.us/lege_ref.htm. Texas Secretary of State. (n.d.).State rules and open meetings. Retrieved from http://www.sos.state.tx.us/texreg/index.shtml Texas Secretary of State. (n.d.). Welcome to the Texas Administrative Code. Retrieved from http://www.sos.state.tx.us/tac/index.shtml As a new APRN understanding delegated prescriptive authority will keep you out of professional and legal trouble. Refer back to Lynda Woolbert’s lecture and differentiate between facility-based and non-facility-based NP practices in Texas law. What does Texas law requires for delegation of prescriptive authority? What is a prescriptive authority agreement (PAA) and what elements should be included? What scheduled drugs can an APRN prescribe and what are the legal requirements associated with prescribing controlled substances? Refer back to the KPRC news clinic (The Harwin Case). Analyze requirements and limitations on a physician’s authority to delegate prescriptive authority in relation to situations in which a physician is delegating prescriptive authority. What do you think the outcome was or should have been for the APRN and the MD? Texas law has two primary...
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...Professional Development of Nursing Professionals, NUR 430, Misty Stone (Instructor) In 2008, The Robert Wood Johnson Foundation (RWJF) and the IOM launched a two-year initiative to respond to the need to assess and transform the nursing profession. A report from the IOM (2010), entitled The Future of Nursing: Leading Change, Advancing Health, recommended transformational changes in nursing education and practice, which position nurses to be a strong influence in shaping healthcare delivery systems, healthcare policy, and overall healthcare practices in the future. The committee developed four key messages. IOM report stated nurses should practice to the full extent of their education and training. Nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression. Nurses should be full partners, with physicians and other health care professionals, in redesigning health care in the United States. Effective workforce planning and policy making require better data collection and information infrastructure. A number of barriers prevent nurses from being able to respond effectively to rapidly changing health care settings and an evolving health care system. These barriers need to be overcome to ensure that nurses are well- positioned to lead change and advance health (IOM,2010) This review of the IOM report will focus on the impact on nursing education, nursing practice, and the nurse’s role as a leader...
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...will greatly affect the delivery of care, and nurses need to be ready to accept the challenges, “The ACA represents the broadest changes to the health care system since the 1965 creation of the Medicare and Medicaid programs and is expected to provide insurance coverage for an additional 32 million previously uninsured Americans. The need to improve the health care system is becoming increasingly evident as challenges related to both the quality and costs of care persist” (IOM report, p. 21). The key factors involved in nurses having the competency to meet the higher standards being set are based on: the transformation of nursing practice, the modification of nursing education, and the cultivation of nurses taking a more active leadership role. Transforming nursing practice can occur several ways. The IOM report stresses the importance of this transformation to take place to improve care of the more diverse population of patients. It states that, “…the system must undergo and fundamental shift to provide patient-centered care; deliver more primary as opposed to specialty care; deliver more care in the community rather than the acute care setting; provide seamless care; enable all health professionals to practice to the full extent of their education , training, and competencies; and foster inter-professional collaboration” (IOM report p.86). With nurses being one of the most...
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...Professional Development of Nursing Professional: The Future of Nursing Grand Canyon University: NRS-430V August 18, 2013 Introduction In 2010, the United States (US) lawmakers approved the Patient Protection and Affordable Care Act (PPACA) attempting to improve the United States health care system by focusing it’s emphasis on cost maintenance, access, and quality of care (Poghosyan, Lucero, Rauch, Berkowitz, 2010). This transformation will now necessitate a restructure of the many roles within the health care professionals, including registered nurses (RNs). In 2008, the Robert Wood Johnson Foundation (RWJF), and the institute of Medicine (IOM) launched a two-year planned response to the critical need to assess and transform the nursing profession (Institute of Medicine, 2010). According to the Institute of Medicine (IOM) report, The Future of Nursing: Leading Changes, Advancing Health, suggest that the future of nursing is advancing with the opportunities that will transform the healthcare system by using knowledge and skills of nursing. The purpose of this discussion focuses on the impacts of the health care reform in nurses’ practice, education, and leadership. The implications on Nursing Education In the US, the health care system is changing dramatically. As the baby boomer population is aging, there has also been a surge of obesity triggering the complexity of chronic illness, such as diabetes, hypertension, and cardiovascular disease. These factors demand...
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...FNP Role Development Katy Lehigh Concordia University Wisconsin FNP Role Development For five decades nurse practitioners have been providing safe, effective, quality primary care services to all ages and populations. As a testament to their commitment and excellence nurse practitioners are being chosen as provider of choice by millions of Americans. Becoming a skilled provider is a dynamic process that occurs over time. Effective role development is essential in becoming a dynamic, compassionate, and knowledgeable clinician. Political Perspective Not all threats to our nation derive from foreign enemies. Our nation suffers within our own borders due to chronic illnesses, rising medical costs, wasted resources, poor coordination of care, and a lack of nationalized healthcare. “America’s health care system is in crisis: It is a ‘sick care’ system, not a health care system” (Blumenthal, 2012). The current healthcare system is fragmented, mismanaged, and poorly financed. Americans receive healthcare insurance through various means, such as government run programs, like Medicare and Medicaid, privately through their employer, private pay, or the purchase through an open market. Regardless of the many healthcare options the United States has to offer, 14.7% of the population remains uninsured (Shi & Singh, 2015, p. 199). “The existence of multiple payers makes the system cumbersome” and poses a billing and collection nightmare for healthcare providers (Shi &...
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