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The Institute of Medicine Report on the Future
of Nursing

The Institute of Medicine (IOM) is an independent and nongovernment
organization that evokes the people in decision-making positions on prevailing health
care issues and suggests how to cross these barriers to improve the healthcare
system, with special emphasis on nursing (IOM, 2010). This paper discusses IOM
report recommendations and its impact on nursing education, practice, roles as
well as this paper’s writer’s practice.

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Impact on Education

recommends that “nurses should achieve higher levels of education and training
through an improved system that promotes seamless academic progression (IOM,
2010).” It suggests increase in percentage of Bachelor of Science in Nursing
(BSN) to 80% and double the number of nurses with masters or doctorate degrees
in total nursing workforce by 2020; provide tuition reimbursement, grants,
loans, salary differential, and promotion as incentives to encourage Associates
Degree in Nursing to BSN; increase diversity to provide culturally relevant patient
care; create a culture to encourage life-long learning; and prepare nursing
graduates with competencies to meet the current and future health demands of
the public (IOM, 2010). Otherwise, nurses would not be able to handle
challenges from the evolving technologies, diverse and aging population
demands. The Robert Wood Johnson Foundation (RWJF) and another study prove the positive
impact of the IOM report on nursing education.

RWJF (2013) illustrates Minnesota Alliance for Nursing
Education (MANE) and Wisconsin-Milwaukee university’s online competency-based
curriculum and “flex option” as a result of the IOM report. Pittman et. Al.
(2015) did multilayer survey that shows progress in raising the proportion of
BSN nurses, nurse residency programs, and opportunities for continuing
education. Improvement in nursing education leads to healthcare practice

Impact on Practice

                IOM (2010),
recommends “Nurses should practice to the full extent of their education and
training.” This is lacking due to the variation in the states’ regulations defining
scope-of-practice; fragmented health care system; aging workforce; high
turn-over rates (staff shortage, workload, technology, etc.); outdated insurance
policies; difficulties of transition from school to practice (lack of proper
orientation, stress, high expectations); and other demographic challenges
(diversity in terms of race, culture, ethnicity, language, age, and gender
preferences) to expanding nurses’ scope of practice (IOM, 2010). To provide
higher-quality, affordable, and safe care, the health care system should enable
nurses to manage and promote health in primary care settings. This is possible
if all the healthcare professionals will practice to the full extent of their

IOM (2010) illustrates Department of Veterans Affairs, Kaiser
Permanente and Geisinger Health system’s investment in nurses’ education,
assessment, coordination, and care, that resulted in cost-effective, affordable,
and significantly better health care system.

RJWF (2013) reflects the impact of this report as the
APRNs are given full practice and prescriptive authority in Nevada state, and
seven other states removed the major barriers to nursing practice and enhanced
high quality, collaborative, and affordable primary care. To access right of
practice to the full extent, IOM (2010) recommends a strong nursing leadership
to redesign the health care system.

IOM Impact on Leadership

to IOM (2010), “nurses should be full partners, with physicians and other
health professionals, in redesigning health care in the United States.” To achieve
this, nurses should actively participate in advisory committees, commissions,
boards, and organizations where decisions are formed to shape policies, advance
health care system, and improve patient care and safety (IOM, 2010). For this,
nurses require knowledge of care delivery system; effective communication,
decision-making, and collaboration skills and competencies; and how to be a
team player. Leadership skills can be innate or achieved through experience,
practice, formal education and training.

(2010) exemplify Integrated Nurse Leadership Program, Best on Board, Robert
Wood Johnson Foundation Executive Nurse Fellow Program, etc. to encourage nurses
to utilize their evidence-based research, practice, and experience to inform
the policy process and argue for high quality, collaborative, and affordable
care in all healthcare settings, political and business domains. To find out
what changes in required in nursing education and practice to advance the
healthcare transformation, policy makers and leadership require reliable and
sufficient data on the healthcare supply and demand, both present and future,
across the healthcare professions. This will be possible with each nurse’s a
strong understanding of the IOM report on the future of nursing, and
determination for life-long education to enhance his or her practice and have
an impact on the healthcare (Saewert, 2016). 

IOM impact on My Practice

While writing this
paper, the writer realizes that emphasis on the patient education and training on
chronic care management and preventive care will be a vital component of her
practice to face challenges emerging due to increased number of insured public,
aged individuals with complex and chronic care, shortage of primary care
physicians, and cost of the healthcare.


report has provided a detailed and evidence-based guidebook for healthcare
professionals to improve the quality and efficiency of the healthcare system by
advancing education, promoting inter-professional collaboration; removing
barriers to practice; cultivating more nurse leaders; diversifying the
profession based on better data collection. To make it a  reality, each nurse must consider personal and
professional goals, and get involved in the process finding a part of it that
means something for him or her.


Institute of Medicine (IOM).
(2010). Future of Nursing Leading Change, Advancing Health. Retrieved


Pittman, P., Bass, E., Hargravas,
J., Herrera, C., &Thompson, P. (2015). The future of nursing: monitoring

progress of recommended change in hospitals, nurse-led clinics, and home health

agencies. Journal of Nursing Administration, 45(2): 95-99.

doi: 10.1097/NNA.0000000000000167

Robert Wood Johnson Foundation
(RWJF). (2013). Three Years Later, Institute of Medicine Report is

Innovations in Nursing Practice and Education. Retrieved from,


Saewert, K.J. (2016). Beyond
Professional Socialization. In Conceptual Foundations: Bridge to

Nursing Practice. (Sixth ed., pp. 38-43). St. Louis, MO. Elsevier. Retrieved

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