Institute Of Medicine Review Paper

Institute of Medicine Review Paper
Penny Isham
NU420
Kelley Madick
10/27/2014

The Institute of Medicine published a report in 2008 with its recommendation to improve the future of Healthcare in our country. There were eight recommendations.
1. Remove the scope of practice barriers
2. Expand opportunities for nurses to lead and diffuse collaborative improvement efforts
3. Implement nurse residency programs
4. Increase the proportion of nurses with a baccalaureate degree to 80 percent by 2020
5. Double the number of nurses with a doctorate by 2020
6. Ensure that nurses engage in lifelong learning
7. Prepare and enable nurses to lead change to advance health
8. Build an infrastructure for the collection and analysis of interprofessional
health care workforce data.
It is easy to see on the surface the benefits each of these recommendations would have on the future of health. There are many things to consider in hopes of making each of these recommendations feasible and come to fruition. Although all recommendations are beneficial I chose to look at recommendation number four; increase nurses with a baccalaureate degree to 80% by 2020. There is a sense of urgency for hospitals to help nurses go back to school.
There are a couple of reasons for this to be beneficial to the hospital, and the nurses involved. Many hospitals are seeking Magnet status. One of the requirements for a hospital to apply for Magnet status is for 80% of the nursing staff to be Bachelors prepared. A hospital receives many benefits with magnet status; nursing quality care, patient results, patient safety, improved work environment, improved nurse satisfaction, and nurse recruitment and retention. A magnet hospital is a status representing a quality hospital. Much of the work implemented in magnet hospitals is completed and implemented by the nurses. Obtaining a bachelor’s degree teaches nurses how to do the research, publish and implement measure and report their work. There really are few if any reasons why this would not help improve nursing knowledge and performance. How can you argue something that will potentially improve the life and health of those we serve, our
patients. “Numerous factors affect successful implementation of planned change”. (Marquis, 2012) Implementing a change with so many nurses has not been an easy undertaking. As stated, once this is achieved the potential to improve practice will benefit the hospitals, the nurse, and the patient. With this in mind there have been changes made at different levels. Many hospitals have improved their tuition reimbursement to their employed nurses to return to school to complete the Bachelor’s degree. The hospital may benefit from improved health outcomes, fewer readmissions, and possible better reimbursement with Magnet status and quality patient outcomes. Some hospitals have even contracted with nursing programs to offer the programs onsite at their hospital. With these benefits, the hospital can also require a commitment to the hospital post-graduation. For many it is very difficult to commit financially to going back to school.
Another difficulty with the decision is time and family balance. This is a long commitment at a very busy, stressful time in many of the nurses’ lives. When thinking of change, consider policies, processes, procedures, products and personnel”. (Lehman, K, V. 24, 2008) One of the ways hospitals can help their nurses go back to school and obtain their degree is to plan resources that will be available to help them be successful. If hospitals could help remove the barriers it would help encourage the nurses to go back to school. When looking at what could possibly be implemented to help the nurses I have thoughts of my own on what I would like to see. If the hospital has an on-site program one of the greatest benefits would be providing child care during class and also for study group time. One of the reason nurses cannot add more to childcare is the high cost of childcare. There could be a potential for other nurses to volunteer to provide the childcare if the hospital provides the space. Providing a mentor / tutor program to help with the struggles will also help lead success. Offering tuition without having to wait for successful completion, rather to pay the tuition then plan for repayment if the student does not pass. Another incentive would be to offer a difference in pay for an associates prepared nurse versus a bachelors prepared
nurse. There has been an increase in funding for nurses to go back to school and there may be an opportunity for grants. We could be ahead of the game if we start pushing for Bachelor’s degree preparation and assisting from the beginning so the students could remain in school. In conclusion, there are many benefits to the recommendations from IOM and few negative other than financial and time constraints. This is the main reason I am back in school. It is a requirement for managers to be Bachelors’ prepared. Nurses are becoming more empowered to guide their practice. We can be the face and voice of how we practice when we use research and best practice to show our patients and employers why we need to be heard.

References
Marquis, B. & Hudson, C. (2012). Leadership Roles and Management Functions in Nursing, 7e [VitalSouce bookshelf version]. Retrieved from http://online.vitalsource.com/books
Lehman, K. (2008) Change management: Magic or mayhem? Journal for nurses in staff development, Volume 24, (4), 176-184