The United States government has identified that a health care reform is needed to ensure that all individuals have access to health care. In March 2010 President Obama signed the Affordable Care Act (ACA) to ensure all individuals in the United States will have access to quality health care ("Key Features Affordable Care ", 2013). Many organizations, including the Institute of Medicine (IOM), recognize that changes need to be made to the current health care system in order for Affordable Care Act to be successful. In 2010 the IOM issued a report reflecting changes needed in health care including: nursing education, nursing practice, and nursing roles as leaders (“Future Nursing”, 2010).
Changes in Education
According to the IOM report, nursing education is one area of health care that requires changes. Currently entry nursing is comprised of nurses with diplomas, associate degrees, baccalaureate degrees, and master's degrees. The IOM's goal is to have 80% of nurses with a minimum of a baccalaureate degree and allow them to practice to the fullest of their education and training by 2020. Health care will be shifting to more patient centered care, focusing on health promotion and preventative care with less acute and specialty care. Associate level nursing curriculums do not prepare nurses with this information; therefore, it is crucial that nurses have a baccalaureate degree to be prepared to care for patients in this changing environment. Since care will be provided in community settings, nurses need to be educated in the following areas: health promotion, preventative health care, primary care, mental health, prenatal services, and geriatric care. Nurses will need to be literate in technology, have good communication skills, transitional care skills, evidence based practice skills, and leadership skills to care for patients in the community setting. In addition to an increased demand for baccalaureate nurses, there