Providing care in this way and in these areas taps traditional strengths of the nursing profession. Achieving such a shift will enable the health care system to provide higher-quality care, reduce errors, and increase safety.
HARMONY ASSISTANT SAMPLE FULL
THE IMPORTANCE OF TRANSFORMING NURSING PRACTICE TO IMPROVE CAREĪs discussed in Chapter 2, the changing landscape of the health care system and the changing profile of the population require that the system undergo a 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 interprofessional collaboration. This is not to say that general registered nurses (RNs) should not have the opportunity to improve their practice and take on new roles the chapter also provides such examples. Particular emphasis is placed on advanced practice registered nurses (APRNs), including their roles in chronic disease management and increased access to primary care, and the regulatory barriers preventing them from taking on these roles. The final section summarizes the committee’s conclusions regarding the vital contributions of the nursing profession to the success of these initiatives as well as the overall transformation of the health care system, and what needs to be done to transform practice to ensure that this contribution is realized. The third section describes the new structures and opportunities made possible by the ACA, as well as through technology.
HARMONY ASSISTANT SAMPLE PROFESSIONAL
The chapter then examines in detail the barriers that constrain this transformation, including regulatory barriers to expanding nurses’ scope of practice, professional resistance to expanded roles for nurses, fragmentation of the health care system, outdated insurance policies, high turnover rates among nurses, difficulties encountered in the transition from education to practice, and demographic challenges. The first section explains why transforming nursing practice to improve care is so important, offering three examples of how utilizing the full potential of nurses has increased the quality of care while achieving greater value. This chapter examines how enabling nurses to practice to the full extent of their education and training ( key message #1 in Chapter 1) can be a major step forward in meeting these challenges. The increase in the insured population and the rapid increase in racial and ethnic minority groups who have traditionally faced obstacles in accessing health care will also demand that care be designed for a more socioeconomically and culturally diverse population. Given the aging population, moreover, the need for long-term and palliative care will continue to grow in the coming years (see Chapter 2). The need for this shift in focus has become particularly urgent with respect to chronic conditions primary care, including care coordination and transitional care prevention and wellness and the prevention of adverse events, such as hospital-acquired infections. health care system away from acute and specialty care. The legislation has begun the long process of shifting the focus of the U.S. The Affordable Care Act of 2010 (ACA) will place many demands on health professionals and offer them many opportunities to create a system that is more patient centered. If the system is to capitalize on this opportunity, however, the constraints of outdated policies, regulations, and cultural barriers, including those related to scope of practice, will have to be lifted, most notably for advanced practice registered nurses.
Nurses have the opportunity to play a central role in transforming the health care system to create a more accessible, high-quality, and value-driven environment for patients. A number of programs and initiatives have already been developed to target necessary improvements in quality, ac cess, and value, and many more are yet to be conceived.
The Affordable Care Act of 2010 outlines some new health care structures, and with these structures will come new opportunities for new roles. Transforming the health care system will in turn require a fundamental rethinking of the roles of many health profession als, including nurses. A transformed health care system is required to achieve this goal. Patients, in all settings, deserve care that is centered on their unique needs and not what is most convenient for the health professionals involved in their care. Key Message #1 : Nurses should practice to the full extent of their education and training.
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