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These case studies offer real-life examples of successful innovations that were developed by nurses or feature nurses in a leadership role, and are meant to complement the peer-reviewed evidence presented in the text. The committee believes these case studies contribute to the evidence base on how nurses can serve in reconceptualized roles to directly affect the quality, accessibility, and value of care. Cumulatively, the case studies and nurse profiles demonstrate what is possible and what the future of nursing could look like under ideal circumstances in which nurses would be highly educated and well prepared by an education system that would promote seamless academic progression, in which nurses would be practicing to the full extent of their education and training, and in which they would be acting as full partners in efforts to redesign the health care system. tadalafil działania uboczne later cialis presentation also cialis 10 mg best price abroad effect of taking tadalafil and viagra together.

As discussed in the preface, this study was undertaken to explore how the nursing profession can be transformed to help exploit these opportunities and contribute to building a health care system that will meet the demand for safe, quality, patient-centered, accessible, and affordable care. This chapter presents the key messages that emerged from the study committee’s deliberations. It begins by describing a vision for a transformed system that can meet the health needs of the U.S. population in the 21st century. The chapter then delineates the roles of nurses in realizing this vision. The third section explains why a fundamental transformation of the nursing profession will be required if nurses are to assume these roles. The final section presents conclusions. medicine news .

The committee recognizes that improved primary care is not a panacea and that acute care services will always be needed. However, the committee sees primary care in community settings as an opportunity to improve health by reaching people where they live, work, and play. Nurses serving in primary care roles could expand access to care, educate people about health risks, promote healthy lifestyles and behaviors to prevent disease, manage chronic diseases, and coordinate care. Care teams need to make the best use of each member’s education, skill, and expertise, and health professionals need to practice to the full extent of their license and education. Just as physicians delegate to registered nurses, then, registered nurses should delegate to front-line caregivers such as nursing assistants and community health workers. Moreover, technology needs to facilitate seamless care that is centered on the patient, rather than taking time away from patient care. In terms of education, efforts must be made to expand the number of nurses who are qualified to serve as faculty. Meanwhile, curricula need to be evaluated, and streamlined and technologies such as high-fidelity simulation and online education need to be utilized to maximize available faculty. Academic–practice partnerships should also be used to make efficient use of resources and expand clinical education sites. The urgency of the situation is masked by current economic conditions. Nursing shortages have historically eased somewhat during difficult economic times, and the past few years of financial turmoil have been no exception (Buerhaus et al., 2009). Nursing is seen as a stable profession—a rare point of security in an unsettled economy. A closer look at the data, however, shows that during the past two recessions, more than three-quarters of the increase in the employment of RNs is accounted for by women and men over age 50, and there are currently more than 900,000 nurses over age 50 in the workforce (BLS, 2009). Meanwhile, the trend from 2001 to 2008 among middle-aged RNs was actually negative, with 24,000 fewer nurses aged 35 to 49. In a hopeful sign for the future, the number of nurses under age 35 increased by 74,000. In terms of absolute numbers, however, the cohorts of younger nurses are still vastly outnumbered by their older Baby Boom colleagues. In other words, the past practice of dependence on a steady supply of older nurses to fill the gaps in the health care system will eventually fail as a strategy (Buerhaus et al., 2009). viagra dan tadalafil relatively cialis sublingual review and cialis 5mg properly problems after using tadalafil. Research on the health care workforce to inform policy deliberations is fragmented and dominated by historical debates over what numbers of a particular health profession are needed and the extent (if at all) to which government should be involved in influencing the supply of and demand for health professionals. The methods used to develop projection models are notoriously deficient and focus on single professions, typically assuming the continuation of current practice and utilization patterns. Projection models do not allow policy makers to test and evaluate the impact of different policy scenarios on supply and demand estimates, whether and how health outcomes are associated with various health professions,

Nurses should move seamlessly through the education system to higher levels of education, including graduate degrees. Nurses with graduate degrees will be able to replenish the nurse faculty pool; advance nursing science and contribute to the knowledge base on how nurses can provide up-to-date, safe patient care; participate in health care decisions; and provide the leadership needed to establish nurses as full partners in health care redesign efforts (see the section on leadership below). medication article At the same time, nurses do not function in a vacuum, but in the context of the skills and perspectives of physicians and other health professionals. Planning for the fundamental changes required to achieve a reformed health care system cannot be accomplished without a clear understanding of the necessary contributions of these various professionals and the numbers and composition of the health care workforce. That understanding in turn cannot be obtained without reliable, sufficiently granular data on the current workforce and projections of future workforce needs. Yet major gaps exist in the currently available workforce data. These gaps hamper the ability to identify and implement the necessary changes to the preparation and practice of nurses and to the overall health care system. Chapter 6 explores these issues in greater detail.

As discussed above, the ACA authorizes the NHWC. It also authorizes a National Center for Workforce Analysis, as well as state and regional workforce centers, and provides funding for workforce data collection and studies. A priority for these new structures and resources should be systematic monitoring of health care workforce shortages and surpluses, review of the data and methods needed to predict future workforce needs, and coordination of the collection of data relating to the health care workforce in federal surveys and in the private sector. These three functions must be actively assumed by the federal government to build the necessary capacity for workforce planning in the United States. The NHWC has the potential to build a robust workforce data infrastructure and a high-level analytic capacity. sildenafil like pills in india certainly the viagra triangle chicago il also online cialis overall what schedule of drug is sildenafil.

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