The Future of Nursing
Leading Change, Advancing Health
Advising the nation/Improving health
For more information visit www.iom.edu/nursing
Report Recommendations
1 RepoRT ReCommeNdATIoNs
Key messages
Nurses should practice to the full extent of their education and training.•
Nurses should achieve higher levels of education and training through an •
improved education system that promotes seamless academic progression.
Nurses should be full partners, with physicians and other health care professionals, •
in redesigning health care in the United States.
Effective workforce planning and policy making require better data collection •
and an improved information infrastructure.
Recommendations
Recommendation 1: Remove scope-of-practice barriers. Advanced practice registered
nurses should be able to practice to the full extent of their education and training. To achieve this goal,
the committee recommends the following actions.
For the Congress:
• Expand the Medicare program to include coverage of advanced practice registered nurse
services that are within the scope of practice under applicable state law, just as physician
services are now covered.
• Amend the Medicare program to authorize advanced practice registered nurses to perform
admission assessments, as well as certification of patients for home health care services and
for admission to hospice and skilled nursing facilities.
• Extend the increase in Medicaid reimbursement rates for primary care physicians included
in the ACA to advanced practice registered nurses providing similar primary care services.
• Limit federal funding for nursing education programs to only those programs in states that
have adopted the National Council of State Boards of Nursing Model Nursing Practice Act
and Model Nursing Administrative Rules (Article XVIII, Chapter 18).
For state legislatures:
• Reform scope-of-practice regulations to conform to the National Council of State Boards
of Nursing Model Nursing Practice Act and Model Nursing Administrative Rules (Article
XVIII, Chapter 18).
• Require third-party payers that participate in fee-for-service payment arrangements to pro-
vide direct reimbursement to advanced practice registered nurses who are practicing within
their scope of practice under state law.
2 THe FuTuRe oF NuRsINg
For the Centers for Medicare and Medicaid Services:
• Amend or clarify the requirements for hospital participation in the Medicare program to
ensure that advanced practice registered nurses are eligible for clinical privileges, admitting
privileges, and membership on medical staff.
For the Office of Personnel Management:
• Require insurers participating in the Federal Employees Health Benefits Program to include
coverage of those services of advanced practice registered nurses that are within their scope
of practice under applicable state law.
For the Federal Trade Commission and the Antitrust Divisi ...
The document outlines Kenya's Vision 2030 plan for improving the health sector. Some key strategies included establishing Kenya as a destination for medical tourism, increasing access to specialized care for Kenyans, promoting local production of health products, developing a human resources strategy to address staffing needs, implementing community-based health programs, increasing funding through a national health insurance scheme, upgrading facilities, and strengthening referral systems. The plan aims to improve healthcare access, quality, and financing across Kenya by 2030.
The Centers for Medicare and Medicaid Services (CMS) State Innovation Models Initiative provides funding to support states in developing and testing innovative healthcare payment and service delivery models. States can apply for one of two types of awards - planning grants of $1-3 million to support model design or testing grants of $20-60 million over 3 years to implement models. The goal is to engage multiple payers and stakeholders to transform healthcare delivery from a volume-based system to one that rewards better health outcomes at lower cost. States must demonstrate how their models will achieve improved health, care experience and affordability through payment and delivery system reform.
Nursing administration in India faces several challenges including a shortage of nurses, low nurse-to-population ratios, and underpaid nursing staff. Current trends in nursing administration include increasing population diversity, rapid technological advances, globalization, a focus on quality care and evidence-based practices, and expanding telehealth. Nursing education must also adapt to these changes by offering more online courses and strengthening nursing research. Addressing issues like staffing, salaries, harassment, and providing continuing education can help overcome challenges in nursing administration in India.
The document discusses various nursing regulatory bodies and their roles in accreditation, renewal, registration, and patient rights. It defines key terms like regulation, accreditation, and licensure. The main regulatory bodies discussed are the International Council of Nurses, Indian Nursing Council, Trained Nurses Association of India, and State Nursing Councils. The goals of regulation are to define the nursing profession, determine scope of practice, set education and ethical standards, and establish accountability. Regulatory bodies work to protect public safety by ensuring qualified practitioners through standards, registration, and monitoring of nursing education and practice.
How do medicaid waivers expand the possibilities of whole person care 032117Jennifer D.
This document discusses how Medicaid waivers can expand whole-person care approaches. It provides examples of whole-person care pilots in California and Minnesota that integrate services across medical, behavioral health, and social services. These pilots aim to improve outcomes, patient experience, and lower costs. The document also discusses how care coordination platforms can help overcome challenges of data sharing, privacy, and interoperability across different provider types to better coordinate whole-person care.
In this August 15, 2012 webinar CMS Innovation Center staff provided additional information for states that are interested in applying for a Model Testing award. Governors' offices were strongly encouraged to onvite their health care innovation team, key stakeholders and appropriate State officials such as State health department directors, Medicaid directors, and insurance commissioners.
- - -
CMS Innovations
http://innovations.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
The document discusses strategies for a new nurse manager to implement to reduce hospital readmissions and improve patient outcomes in compliance with new regulations. It instructs the nurse manager to integrate interprofessional collaboration and communication among nursing staff and leaders, create a plan using advanced leadership roles to promote excellent patient outcomes, and plan a healthcare delivery system that manages resources in a fiscally responsible way to provide high-quality care. The nurse manager is asked to apply one of the nine Master's of Science in Nursing (MSN) essential interventions to their plan.
The document outlines Kenya's Vision 2030 plan for improving the health sector. Some key strategies included establishing Kenya as a destination for medical tourism, increasing access to specialized care for Kenyans, promoting local production of health products, developing a human resources strategy to address staffing needs, implementing community-based health programs, increasing funding through a national health insurance scheme, upgrading facilities, and strengthening referral systems. The plan aims to improve healthcare access, quality, and financing across Kenya by 2030.
The Centers for Medicare and Medicaid Services (CMS) State Innovation Models Initiative provides funding to support states in developing and testing innovative healthcare payment and service delivery models. States can apply for one of two types of awards - planning grants of $1-3 million to support model design or testing grants of $20-60 million over 3 years to implement models. The goal is to engage multiple payers and stakeholders to transform healthcare delivery from a volume-based system to one that rewards better health outcomes at lower cost. States must demonstrate how their models will achieve improved health, care experience and affordability through payment and delivery system reform.
Nursing administration in India faces several challenges including a shortage of nurses, low nurse-to-population ratios, and underpaid nursing staff. Current trends in nursing administration include increasing population diversity, rapid technological advances, globalization, a focus on quality care and evidence-based practices, and expanding telehealth. Nursing education must also adapt to these changes by offering more online courses and strengthening nursing research. Addressing issues like staffing, salaries, harassment, and providing continuing education can help overcome challenges in nursing administration in India.
The document discusses various nursing regulatory bodies and their roles in accreditation, renewal, registration, and patient rights. It defines key terms like regulation, accreditation, and licensure. The main regulatory bodies discussed are the International Council of Nurses, Indian Nursing Council, Trained Nurses Association of India, and State Nursing Councils. The goals of regulation are to define the nursing profession, determine scope of practice, set education and ethical standards, and establish accountability. Regulatory bodies work to protect public safety by ensuring qualified practitioners through standards, registration, and monitoring of nursing education and practice.
How do medicaid waivers expand the possibilities of whole person care 032117Jennifer D.
This document discusses how Medicaid waivers can expand whole-person care approaches. It provides examples of whole-person care pilots in California and Minnesota that integrate services across medical, behavioral health, and social services. These pilots aim to improve outcomes, patient experience, and lower costs. The document also discusses how care coordination platforms can help overcome challenges of data sharing, privacy, and interoperability across different provider types to better coordinate whole-person care.
In this August 15, 2012 webinar CMS Innovation Center staff provided additional information for states that are interested in applying for a Model Testing award. Governors' offices were strongly encouraged to onvite their health care innovation team, key stakeholders and appropriate State officials such as State health department directors, Medicaid directors, and insurance commissioners.
- - -
CMS Innovations
http://innovations.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
The document discusses strategies for a new nurse manager to implement to reduce hospital readmissions and improve patient outcomes in compliance with new regulations. It instructs the nurse manager to integrate interprofessional collaboration and communication among nursing staff and leaders, create a plan using advanced leadership roles to promote excellent patient outcomes, and plan a healthcare delivery system that manages resources in a fiscally responsible way to provide high-quality care. The nurse manager is asked to apply one of the nine Master's of Science in Nursing (MSN) essential interventions to their plan.
Journal #4Journals The Journals should be a synopsis of ALL yo.docxchristiandean12115
Journal #4:
Journals: The Journals should be a synopsis of ALL your required readings and PowerPoints. These papers are 4-6 pages long and include a title and reference page. Tell me what you learned. Failure to cover any aspect of the information will result is loss of points. Spelling and grammar issues will result in loss of points.
· All papers must use appropriate sentence structure, grammar, organization, punctuation and spelling.
· All papers must demonstrate evidence of logical development of thought, clarity, and organization.
· To be accepted for grading, all written papers will be typed and consistent with APA
Textbook(s):
Required:
Mason, D. J., Gardner, D. B., Outlaw, F. H., & O’Grady, E. T. (2016).Policy & politics in
nursing and health care (7th ed.) St. Louis: Elsevier.
(ISBN: 978-0-323-24144-1).
Greer, G. & Fitzpatrick, J. J. (2013). Nursing leadership: From the outside in. New York, NY:
Springer.
(ISBN: 978-0-8261-0866-1).
Policy and Politics in the Government
Mason Textbook:
Chapters: 40-55
Policy and Politics in the Workplace and Workforce
Mason Textbook:
Chapters:56-71
Glazer Chapters13, 18, 19
Policy and Politics in Associations and Special Interest Groups
Mason Textbook:
Chapters: 72-80
Policy and Politics in the Community
Mason Textbook:
Chapters: 81-92
Glazer Remaining Chapters
https://www.youtube.com/watch?v=lr1kDPM8kao
https://www.youtube.com/watch?v=pCYfQmk5yao
https://www.youtube.com/watch?v=NhhYqRjGzBk
https://www.youtube.com/watch?v=FFroMQlKiag
https://blackboard.fmarion.edu/bbcswebdav/pid-188128-dt-content-rid-546929_1/xid-546929_1
https://blackboard.fmarion.edu/bbcswebdav/pid-191673-dt-content-rid-584514_1/courses/APRN504-5886-Spring2016/APRN%20Map%20%281%29.jpg
https://www.youtube.com/watch?v=BjsvCe1vpiw
https://www.youtube.com/watch?v=4naF9GNxcRU
https://www.youtube.com/watch?v=WPIA2HC3Vk8
https://www.youtube.com/watch?v=ppstyrLTzOI
https://www.youtube.com/watch?v=nWJcFl6f81s
https://www.youtube.com/watch?v=dEsDF3Hlaqs
https://www.youtube.com/watch?v=QKEL2TZoIZs
https://www.youtube.com/watch?v=ccFRPbisCPo
https://www.youtube.com/watch?v=WgfFG7gmM8E
https://www.youtube.com/watch?v=5Lul6KNIw_8
https://www.youtube.com/watch?v=u6tZpX8Uw8o
https://www.youtube.com/watch?v=hlMjSoO3CWQ
https://www.youtube.com/watch?v=oXjxeQuhdAs
https://www.youtube.com/watch?v=fUCs_Kdpl-U
https://www.youtube.com/watch?v=ol1cah8zItk
https://www.youtube.com/watch?v=gf2bObJGFkg
https://www.youtube.com/watch?v=0PjrZVHeXn4
IOM committee releases 10 recommendations for the future of nursing
Written by Kelly Gooch | December 04, 2015
The Institute of Medicine this week released an evaluation on its 2010 landmark "The Future of Nursing: Leading Change, Advancing Health" report.
The report made a series of recommendations pertaining to the roles for nurses in the 2010 healthcare landscape.
Shortly after release of the report, AARP and the Robert Wood Johnson Foundation launched the Future of Nurs.
Role of Community Matrons in shifts in settings of care Care City
The document discusses the political context driving healthcare reforms in the UK and the expected shift toward more community-based care delivery away from hospitals. Community matrons and practice nurses can contribute to this shift by participating in whole-systems approaches, sharing knowledge and best practices, and participating in ongoing service redesign. The new model of care should focus on prevention, self-care, coordination, and consistent high-quality care both in specialist and community settings through greater integration between primary and secondary care teams.
Transforming Clinical Practice InitiativeCitiusTech
The Transforming Clinical Practice Initiative (TCPI) is designed to help small practices and clinicians achieve large-scale health transformation. The initiative is designed to support more than 140,000 clinician practices over four years duration in sharing, adapting and further developing their comprehensive quality improvement strategies. The TCPI is one part of a unique strategy advanced by the Affordable Care Act to strengthen the quality of patient care and manage health care expenditures, ultimately saving the taxpayer from substantial costs. This document describes the initiative in detail with the type of participants, eligibility and reporting requirements of the participants. Understanding the implementation of this initiative not only helps clinicians, but opens up a huge market for Healthcare IT companies offering the products and services like EHR implementation, Integration, EHR/ Data Migration, Implementation of HIE etc.
This document provides details about two nursing students, their registration numbers, class, and the institution they attend. It then summarizes Kenya's Vision 2030, which aims to transform Kenya into a prosperous middle-income country by 2030. The social pillar of Vision 2030 focuses on improving eight social sectors, including education, health, water and sanitation. This document specifically focuses on the health sector and outlines several flagship projects and strategies to improve healthcare, such as developing locally produced natural health products, modernizing major hospitals, implementing e-health systems, and improving access to referral services.
The documents discuss changes in the US healthcare system focusing on quality improvement initiatives. It summarizes frameworks from the Institute for Clinical Systems Improvement (ICSI) and Regional Health Improvement Collaboratives (RHIC) that provide guidelines and coordinate multi-stakeholder efforts to reform payment systems, improve care delivery, and increase community health. It also describes the Quality Alliance Steering Committee's (QASC) work measuring healthcare quality nationally through organizations like MN Community Measurement. The overall goal is to shift focus from sickness to prevention by increasing access to high-quality, coordinated care.
Education and training program in the hospital.pptxSangam Kanthale
1. The document discusses education and training programs in hospitals, including proper training for all staff on safe patient handling, demonstrations on equipment use and maintenance, and involving patients and families.
2. It describes best practices for training programs in hospitals, such as using different learning styles, interactive programs, computer-based modules, and evaluating effectiveness.
3. The roles of pharmacists are outlined, including instructing on medications, monitoring drug use, and training other healthcare workers.
The Obama Record 2009-2017 - Health CareJeremy Shih
The document summarizes the major provisions and impacts of the Affordable Care Act (ACA) passed under President Obama after decades of failed attempts at health care reform. It outlines how the ACA expanded access to affordable health insurance through the creation of state health insurance exchanges, extended dependent coverage, prohibited denying coverage due to pre-existing conditions, and provided subsidies for low-income individuals. It also discusses how the ACA aimed to improve quality and lower costs through initiatives like accountable care organizations, reduced "donut hole" prescription drug costs for seniors, and increased transparency.
The 5 Year Forward View document outlines several new models of care to transform healthcare services in England:
1. Multispecialty Community Providers that would serve as the focal point for a wide range of care in the community, potentially employing consultants and taking over community hospitals.
2. Primary and Acute Care Systems that integrate primary care, hospital, mental health, and community services under one organization with a delegated capitated budget.
3. Urgent and Emergency Care Networks that integrate A&E, GP out-of-hours care, urgent care centers, NHS 111, and ambulance services.
Factors affecting hospital expenditure and role of nurse.pptxNisha Yadav
Microteaching on factors affecting health expenditure and the role of nurses in fiscal planning of nursing expenditure. The document discusses health expenditure, determinants of health expenditure including income, technology, and population. It also discusses hospital expenditure and factors affecting it such as economic events, new technologies, labor shortages, and inflation. The importance of fiscal planning for objectives, policies, and utilization of resources is explained. Finally, the role of nurses in the fiscal planning process is described, including participating in budget preparation, monitoring costs, and justifying resource allocation for quality patient care.
Case study on establishing low cost hospitals in 4 states with low health ind...Shubhenduchakravorty
This Case Study was created for a specific purpose of exploring a model to establish and clarify operational details of Low Cost Healthcare Hospitals in the States of Bihar, Jharkhand, Chhattisgarh and Madhya Pradesh. The name of the Hospital and the base presumptions are fictitious. However, all data used in the Case Study and the Models are genuine and referred from various sources.
William Shrank: Payment reform activities at CMSNuffield Trust
The document discusses activities at the CMS Innovation Center to test new payment and service delivery models. It outlines several initiatives to improve care coordination, such as ACO models and medical home programs. It also discusses initiatives to improve care quality like Partnership for Patients and reduce costs through bundled payments. Rapid-cycle evaluation is highlighted as important to provide feedback to support continuous quality improvement and identify successful models to scale nationally.
The article discusses the patient medical home model for creating an integrated healthcare system with improved coordination of care. A patient medical home is a longitudinal general practice supported by a team including physicians and other healthcare professionals. The model aims to enhance support for patients, particularly vulnerable groups, through strengthened connections between providers. Examples of similar models in Ontario and Alberta integrating primary care teams within communities are provided. The goals of BC's patient medical home initiative through the General Practice Services Committee include increasing access to quality primary care and contributing to a more effective and sustainable healthcare system.
Nursing has long included an educational role in patient care. Major developments established patient education standards and recognized teaching as a nursing function. Current trends emphasize empowering patients through self-management education and preparing nurses for evolving health education roles. However, barriers like lack of time challenge effective teaching. Ongoing research aims to improve teaching methods and evaluate educational outcomes.
Nursing has long included an educational component, with patient teaching recognized as a core nursing function. The nurse educator role has evolved in several ways, such as through the establishment of standards and mandates requiring patient education. While nurses face barriers to effective teaching like lack of time, their role as educator extends beyond patient teaching to include students, staff and the public. Ongoing issues involve ensuring education is tailored to diverse learners and coordinated between healthcare teams.
This resource summarizes the eight recommendations outlined in the Institute of Medicine's a new consensus study entitled, Improving Diagnosis in Health Care. The recommendations are aimed at making diagnoses more accurate, reliable, efficient, and safe. This work is a continuation of the IOM’s Quality Chasm series.
Sharon Kulesz is an accomplished healthcare professional with over 20 years of experience in healthcare education, management, and professional development. She has held leadership roles at organizations such as the American College of Radiology, Alliance for Continuing Education in the Health Professions, and American Academy of Physician Assistants, where she developed and managed educational programs, oversaw operations and budgets, and strengthened relationships with partners. Kulesz has expertise in areas like curriculum development, program management, and facilitating continuing education in various settings. She is passionate about developing educational opportunities to advance healthcare professionals.
The document discusses the importance of education and training programs in hospitals, which includes undergraduate and graduate medical programs, training nurses, technicians, and other staff. It describes the roles of pharmacists in various internal and external teaching programs that educate students, residents, medical staff, and the public. The goal of these programs is to improve the knowledge and skills of healthcare workers and patients.
All scientific theories must be able to make testable predictions. S.docxoreo10
The document discusses the concepts of phyletic gradualism and punctuated equilibrium, two theories of how evolution occurs. Punctuated equilibrium predicts a fossil record with long periods of little change punctuated by short periods of rapid evolution. It suggests rapid evolution is driven by environmental pressures while periods of stasis are due to stabilizing evolutionary factors. The debate between these two theories continues as evidence both supports gradual evolution as well as punctuated periods of rapid change throughout the fossil record.
All I wnat is to write a reflection paper on my project which is hac.docxoreo10
All I wnat is to write a reflection paper on my project which is hacking tools
My project is about using those 5 tools :
1-
Ice Hole for
Phishing
2-
SocialKlepto for
Social
3-
SmartphonePF and
Mactans
for Mobile
4-
Hping and
Yersinia for networks
5-
LCP and
Cain and Abel for
PasswordCracking
.
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· All papers must use appropriate sentence structure, grammar, organization, punctuation and spelling.
· All papers must demonstrate evidence of logical development of thought, clarity, and organization.
· To be accepted for grading, all written papers will be typed and consistent with APA
Textbook(s):
Required:
Mason, D. J., Gardner, D. B., Outlaw, F. H., & O’Grady, E. T. (2016).Policy & politics in
nursing and health care (7th ed.) St. Louis: Elsevier.
(ISBN: 978-0-323-24144-1).
Greer, G. & Fitzpatrick, J. J. (2013). Nursing leadership: From the outside in. New York, NY:
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Policy and Politics in the Workplace and Workforce
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Chapters:56-71
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Policy and Politics in Associations and Special Interest Groups
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https://www.youtube.com/watch?v=lr1kDPM8kao
https://www.youtube.com/watch?v=pCYfQmk5yao
https://www.youtube.com/watch?v=NhhYqRjGzBk
https://www.youtube.com/watch?v=FFroMQlKiag
https://blackboard.fmarion.edu/bbcswebdav/pid-188128-dt-content-rid-546929_1/xid-546929_1
https://blackboard.fmarion.edu/bbcswebdav/pid-191673-dt-content-rid-584514_1/courses/APRN504-5886-Spring2016/APRN%20Map%20%281%29.jpg
https://www.youtube.com/watch?v=BjsvCe1vpiw
https://www.youtube.com/watch?v=4naF9GNxcRU
https://www.youtube.com/watch?v=WPIA2HC3Vk8
https://www.youtube.com/watch?v=ppstyrLTzOI
https://www.youtube.com/watch?v=nWJcFl6f81s
https://www.youtube.com/watch?v=dEsDF3Hlaqs
https://www.youtube.com/watch?v=QKEL2TZoIZs
https://www.youtube.com/watch?v=ccFRPbisCPo
https://www.youtube.com/watch?v=WgfFG7gmM8E
https://www.youtube.com/watch?v=5Lul6KNIw_8
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https://www.youtube.com/watch?v=hlMjSoO3CWQ
https://www.youtube.com/watch?v=oXjxeQuhdAs
https://www.youtube.com/watch?v=fUCs_Kdpl-U
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https://www.youtube.com/watch?v=0PjrZVHeXn4
IOM committee releases 10 recommendations for the future of nursing
Written by Kelly Gooch | December 04, 2015
The Institute of Medicine this week released an evaluation on its 2010 landmark "The Future of Nursing: Leading Change, Advancing Health" report.
The report made a series of recommendations pertaining to the roles for nurses in the 2010 healthcare landscape.
Shortly after release of the report, AARP and the Robert Wood Johnson Foundation launched the Future of Nurs.
Role of Community Matrons in shifts in settings of care Care City
The document discusses the political context driving healthcare reforms in the UK and the expected shift toward more community-based care delivery away from hospitals. Community matrons and practice nurses can contribute to this shift by participating in whole-systems approaches, sharing knowledge and best practices, and participating in ongoing service redesign. The new model of care should focus on prevention, self-care, coordination, and consistent high-quality care both in specialist and community settings through greater integration between primary and secondary care teams.
Transforming Clinical Practice InitiativeCitiusTech
The Transforming Clinical Practice Initiative (TCPI) is designed to help small practices and clinicians achieve large-scale health transformation. The initiative is designed to support more than 140,000 clinician practices over four years duration in sharing, adapting and further developing their comprehensive quality improvement strategies. The TCPI is one part of a unique strategy advanced by the Affordable Care Act to strengthen the quality of patient care and manage health care expenditures, ultimately saving the taxpayer from substantial costs. This document describes the initiative in detail with the type of participants, eligibility and reporting requirements of the participants. Understanding the implementation of this initiative not only helps clinicians, but opens up a huge market for Healthcare IT companies offering the products and services like EHR implementation, Integration, EHR/ Data Migration, Implementation of HIE etc.
This document provides details about two nursing students, their registration numbers, class, and the institution they attend. It then summarizes Kenya's Vision 2030, which aims to transform Kenya into a prosperous middle-income country by 2030. The social pillar of Vision 2030 focuses on improving eight social sectors, including education, health, water and sanitation. This document specifically focuses on the health sector and outlines several flagship projects and strategies to improve healthcare, such as developing locally produced natural health products, modernizing major hospitals, implementing e-health systems, and improving access to referral services.
The documents discuss changes in the US healthcare system focusing on quality improvement initiatives. It summarizes frameworks from the Institute for Clinical Systems Improvement (ICSI) and Regional Health Improvement Collaboratives (RHIC) that provide guidelines and coordinate multi-stakeholder efforts to reform payment systems, improve care delivery, and increase community health. It also describes the Quality Alliance Steering Committee's (QASC) work measuring healthcare quality nationally through organizations like MN Community Measurement. The overall goal is to shift focus from sickness to prevention by increasing access to high-quality, coordinated care.
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1. The document discusses education and training programs in hospitals, including proper training for all staff on safe patient handling, demonstrations on equipment use and maintenance, and involving patients and families.
2. It describes best practices for training programs in hospitals, such as using different learning styles, interactive programs, computer-based modules, and evaluating effectiveness.
3. The roles of pharmacists are outlined, including instructing on medications, monitoring drug use, and training other healthcare workers.
The Obama Record 2009-2017 - Health CareJeremy Shih
The document summarizes the major provisions and impacts of the Affordable Care Act (ACA) passed under President Obama after decades of failed attempts at health care reform. It outlines how the ACA expanded access to affordable health insurance through the creation of state health insurance exchanges, extended dependent coverage, prohibited denying coverage due to pre-existing conditions, and provided subsidies for low-income individuals. It also discusses how the ACA aimed to improve quality and lower costs through initiatives like accountable care organizations, reduced "donut hole" prescription drug costs for seniors, and increased transparency.
The 5 Year Forward View document outlines several new models of care to transform healthcare services in England:
1. Multispecialty Community Providers that would serve as the focal point for a wide range of care in the community, potentially employing consultants and taking over community hospitals.
2. Primary and Acute Care Systems that integrate primary care, hospital, mental health, and community services under one organization with a delegated capitated budget.
3. Urgent and Emergency Care Networks that integrate A&E, GP out-of-hours care, urgent care centers, NHS 111, and ambulance services.
Factors affecting hospital expenditure and role of nurse.pptxNisha Yadav
Microteaching on factors affecting health expenditure and the role of nurses in fiscal planning of nursing expenditure. The document discusses health expenditure, determinants of health expenditure including income, technology, and population. It also discusses hospital expenditure and factors affecting it such as economic events, new technologies, labor shortages, and inflation. The importance of fiscal planning for objectives, policies, and utilization of resources is explained. Finally, the role of nurses in the fiscal planning process is described, including participating in budget preparation, monitoring costs, and justifying resource allocation for quality patient care.
Case study on establishing low cost hospitals in 4 states with low health ind...Shubhenduchakravorty
This Case Study was created for a specific purpose of exploring a model to establish and clarify operational details of Low Cost Healthcare Hospitals in the States of Bihar, Jharkhand, Chhattisgarh and Madhya Pradesh. The name of the Hospital and the base presumptions are fictitious. However, all data used in the Case Study and the Models are genuine and referred from various sources.
William Shrank: Payment reform activities at CMSNuffield Trust
The document discusses activities at the CMS Innovation Center to test new payment and service delivery models. It outlines several initiatives to improve care coordination, such as ACO models and medical home programs. It also discusses initiatives to improve care quality like Partnership for Patients and reduce costs through bundled payments. Rapid-cycle evaluation is highlighted as important to provide feedback to support continuous quality improvement and identify successful models to scale nationally.
The article discusses the patient medical home model for creating an integrated healthcare system with improved coordination of care. A patient medical home is a longitudinal general practice supported by a team including physicians and other healthcare professionals. The model aims to enhance support for patients, particularly vulnerable groups, through strengthened connections between providers. Examples of similar models in Ontario and Alberta integrating primary care teams within communities are provided. The goals of BC's patient medical home initiative through the General Practice Services Committee include increasing access to quality primary care and contributing to a more effective and sustainable healthcare system.
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Nursing has long included an educational component, with patient teaching recognized as a core nursing function. The nurse educator role has evolved in several ways, such as through the establishment of standards and mandates requiring patient education. While nurses face barriers to effective teaching like lack of time, their role as educator extends beyond patient teaching to include students, staff and the public. Ongoing issues involve ensuring education is tailored to diverse learners and coordinated between healthcare teams.
This resource summarizes the eight recommendations outlined in the Institute of Medicine's a new consensus study entitled, Improving Diagnosis in Health Care. The recommendations are aimed at making diagnoses more accurate, reliable, efficient, and safe. This work is a continuation of the IOM’s Quality Chasm series.
Sharon Kulesz is an accomplished healthcare professional with over 20 years of experience in healthcare education, management, and professional development. She has held leadership roles at organizations such as the American College of Radiology, Alliance for Continuing Education in the Health Professions, and American Academy of Physician Assistants, where she developed and managed educational programs, oversaw operations and budgets, and strengthened relationships with partners. Kulesz has expertise in areas like curriculum development, program management, and facilitating continuing education in various settings. She is passionate about developing educational opportunities to advance healthcare professionals.
The document discusses the importance of education and training programs in hospitals, which includes undergraduate and graduate medical programs, training nurses, technicians, and other staff. It describes the roles of pharmacists in various internal and external teaching programs that educate students, residents, medical staff, and the public. The goal of these programs is to improve the knowledge and skills of healthcare workers and patients.
All scientific theories must be able to make testable predictions. S.docxoreo10
The document discusses the concepts of phyletic gradualism and punctuated equilibrium, two theories of how evolution occurs. Punctuated equilibrium predicts a fossil record with long periods of little change punctuated by short periods of rapid evolution. It suggests rapid evolution is driven by environmental pressures while periods of stasis are due to stabilizing evolutionary factors. The debate between these two theories continues as evidence both supports gradual evolution as well as punctuated periods of rapid change throughout the fossil record.
All I wnat is to write a reflection paper on my project which is hac.docxoreo10
All I wnat is to write a reflection paper on my project which is hacking tools
My project is about using those 5 tools :
1-
Ice Hole for
Phishing
2-
SocialKlepto for
Social
3-
SmartphonePF and
Mactans
for Mobile
4-
Hping and
Yersinia for networks
5-
LCP and
Cain and Abel for
PasswordCracking
.
Alice,Betty, and Carol are playing a game with 48 marbles in a circl.docxoreo10
Alice,Betty, and Carol are playing a game with 48 marbles in a circle. Alice takes 2 marbles. Betty takes 4 marbles and Carol takes 6 marbles. One of them (not saying which one) now takes as many marbles as she did the first time. Another girl takes twice as many as she had before and the remaining girl takes 4 times as many as before. There are now 10 marbles left in the circle. Which girl took the same amount as the first time?
.
All healthcare organizations must convert to an Electronic Health Re.docxoreo10
The local hospital must purchase a $1.5 million electronic health record system by 2014 to comply with federal mandates. A proposal should be prepared for hospital management that includes financing options as well as strategic plans for administering, operating, and marketing the new EHR system to ensure a smooth transition.
All round writer onlyThis is an individual Mediation assignment..docxoreo10
All round writer only
This is an individual Mediation assignment.
Read the attached information.
Assume the first role, that of Samantha (Sam) Pinder,
Executive V.P. of Finance, a mediator/facilitator . Two other roles are also printed out to assist you in understanding how the parties view the dispute.
Resolve
this dispute using the Steps in the Mediation Process and the Mediator's guide which follow the role information.
Describe the
outcome
for all parties.
.
Alice was wondering whether it was a good idea to invest her money i.docxoreo10
Alice was wondering whether it was a good idea to invest her money in treasury bonds. Discuss with Alice the pros and cons of that type of investment, contrasting U.S. treasuries to other sovereign debt. Be sure to include a discussion of risk. Also, show her the different types of bonds that exist in the corporate world.
-400-600 words
- Please include references
.
All organisms have DNA, which differs only in the number and order o.docxoreo10
All organisms have DNA, which differs only in the number and order of each type of nucleotide. This suggests that all organisms have
Answers available in ...
10
Take this time to do your
best on this question.
Eliminate
Reactivate
Eliminate
Reactivate
Eliminate
Reactivate
.
All literature involves some kind of performance which is intended f.docxoreo10
All literature involves some kind of performance which is intended for an audience. Sometimes, however, the performative quality of a work (i.e., the fact that it is being presented to an audience) is more obvious than at others. Drama and poetry, for example, tend to emphasize overt performance more than do short stories, which more often are read silently and in solitude.
How is the more direct performative aspect of drama and/or poetry reflected in these forms? (Consider for example, each genre’s uses of literary structure, language, technique, and style.) How do these literary elements affect your reading experience?
In your post, identify key qualities of drama and poetry which emphasize their performative qualities. Discuss how these characteristics shape your reading response. Support your views with
at least one example of a dramatic text and one example of a poem
.
.
All key elements of the assignment are covered in a substantiv.docxoreo10
All key elements of the assignment are covered in a substantive way.
·
Presentation follows the timeline of the evolution of business.
·
Presentation provides information on the different stages of business evolution, including:
o
Feudalism
o
Mercantilism
o
Capitalism
o
Commerce
o
Property rights
o
The Industrial Revolution
·
Presentation consists of 10 to 15 slides appropriate for the speaker’s audience.
·
Speaker notes are included for each slide.
·
Title and APA reference slide are included.
.
Alice, Betty and Carol are playing a game with 48 marbles in a circl.docxoreo10
Alice, Betty and Carol took marbles from a circle of 48 marbles, with Alice taking 2, Betty taking 4, and Carol taking 6. One girl took the same amount as the first time, another girl took twice as many as before, and the remaining girl took 4 times as many as before, leaving 10 marbles left. Carol took the same amount as the first time.
Alice Jones was employed as a clerk-typist by a company. She request.docxoreo10
Alice Jones was employed as a clerk-typist by a company. She requested and was refused a vacation day. The employer's refusal was based on her failure to submit the request at least two weeks in advance as required by company policy. She announced that she would take the day anyway, and when she subsequently failed to report for work, was fired for insubordination, plus the unexcused absence. Jones claimed that the company's real reason for firing her was a complaint that she had made to her state's department of labor concerning elimination of employee rest breaks. Explain and evaluate the possible causes of action available to Jones, and identify and explain the possible defenses available to Jones’ employer with regard to each cause of action. Integrate case law and statutory support into your response. (Points : 30)
.
Air and Water Pollution PaperAir and water pollutants exist in m.docxoreo10
Air and Water Pollution Paper
Air and water pollutants exist in many forms. Understanding what they are and where they come from better equips you to address the issues of air and water pollution.
Select
two types of air pollutants and two types of water pollutants.
Write
a 950 paper in which you analyze your selected pollutants and their effect on the environment. In your analysis, include the following items:
·
Indicate whether the selected air pollutants are considered primary or secondary pollutants. Explain why they are considered to be primary or secondary and discuss the sources of these pollutants.
·
Describe how the selected air pollutants affect the different layers of the atmosphere. In looking at this interaction, how do greenhouse gases influence Earth’s climate? Discuss how these air pollutants and greenhouse gases affect human, plant, and animal life.
·
Examine the selected water pollutants. Discuss the sources of these pollutants and indicate their effects on water resources and aquatic life.
·
Discuss the effect of poor water quality on humans and the environment. What are some solutions for reducing poor water quality?
Cite
at least two references.
Format
your paper consistent with APA guidelines.
.
Air pollution is an environmental health problem in many cities thro.docxoreo10
Air pollution is an environmental health problem in many cities throughout the world. Residents in an urban community through which a major freeway transportation route runs are suffering from a number of health effects. The local organization arranges for you, a health educator, to consult with and assist a nurse from a local community clinic in
planning and implementing
a program that will address reduction in exposure of the community, particularly children, to air pollution and thereby reducing the impact of air pollution in the community.
Write a 2-3 page paper in which you do the following:
1. Describe the common health problems associated with
indoor and outdoor air pollution
in urban settings.
2. Describe why children are more vulnerable to the effects of air pollutants.
3. Describe how you (as a Health Educator and consultant in this multi-disciplinary team), would assist the nurse to
plan and implement
a program that will reduce the exposure of this community to air pollution as well as reduce the impact of air pollution on the health of children. In your response, make sure to include preventive steps that can be taken by the community (home and school, for example) to reduce the exposure of children to air pollutants.
.
After your topic has been approved, the next step is to research.docxoreo10
After your topic has been approved, the next step is to research current articles and publications (within one year) and write an outline. You will need to use at least six credible sources that provide objective, authoritative, and accurate descriptions of your selected microeconomics topic. Two of your sources must be from academic journals. Your sources can include the following:
Academic journals
Financial and economic publications like the Wall Street Journal, the Economist, and industry-specific publications
Newspapers such as the New York Times and the Washington Post
Research databases like ProQuest
Use the
Hunt Library (Links to an external site.)
to conduct your research. Do not use Investopedia or Wikipedia.
You may write a formal outline or present your information in paragraph form using current APA formatting. Regardless of the outline format, you must provide the following:
Details that align with your microeconomics topic
List of your sources
Two of the sources must be from academic journals.
.
After watching three of the five movie clips listed in the Multime.docxoreo10
After watching three of the five movie clips listed in the
Multimedia
section, above, describe how they fit into a specific genre (or subgenre) as explained in the text. What elements of the film are characteristic of that genre? How does it fulfill the expectations of that genre? How does it play against these expectations?
.
Aging and Disability WorksheetPart IIdentify 2 or .docxoreo10
Aging and Disability Worksheet
Part I
Identify 2 or 3 issues faced by the aging population.
1.
2.
3.
Answer the following questions in 100 to 200 words each
.
Provide citations for all
the
sources
you use
.
·
What is ageism? How does ageism influence the presence of diversity in society?
·
What is the
Age
Dis
criminitation in Employment
Act (AD
E
A)? How does the AD
E
A address issues for the aging population?
·
What is being done to address the issues you identified?
·
Is the number of aging population expected to rise in numbers or decrease?
·
What types of legislation may or may not be affected by the aging population?
·
How does poverty affect the aging population?
Part II
Answer the following questions in 100 to 200 words each
.
Provide citations for all
the
sources
you use
.
·
What does the ADA provide for people with disabilities?
·
How have people with disabilities been treated in the past?
·
How has the attitude toward people with disabilities changed over time?
·
What are some unique circumstances or issues encountered by people with disabilities?
·
What is being done to address those issues?
·
What types of legislation have been introduced to address issues faced by people with disabilities?
.
After watching the video and reading the Web Resource, CDC Autism .docxoreo10
After watching the video and reading the Web Resource, "CDC: Autism Spectrum Disorders: Signs and Symptoms," discuss how you as an early childhood professional can use this information to increase awareness and early identification of autism, specifically discussing assessment tools that can be used with children with autism.
.
AI Artificial Intelligence1Reading responsePeter .docxoreo10
AI: Artificial Intelligence
1
Reading response
Peter Dormer, “Craft and the Turing Test for Practical Thinking,” in The Challenge of Technology.
What is personal know-how? What is distributed knowledge?
How do they relate to the Turing test?
Give one example of your own how these concepts matter today to artists and makers, or better yet, in your own experience?
Journal homework
Keep a record (text and drawings) of events in daily life where human and machine intersect and interact. Fill at least two pages with your observations.
Mary Shelley, Frankenstein, or The Modern Prometheus, 1818
Boris Karloff in Frankenstein in 1931 directed by James Whale
Mary Shelley first published Frankenstein, or the Modern Prometheus 1818. the novel allegorizes the Romantic obsession with discovering the power or principle of life. Ideas about a life power were consistent with the scientific understanding of the day. Darwin himself spoke of an organizing “spirit of animation” in his Zoonomia; or, The Laws of Organic Life, in which he stated “the world itself might have been generated, rather than created.”
Dr. Frankenstein picked all the parts for his monster based on their beauty, but when it comes to life, the monster is unbearably ugly. “I had worked hard for nearly two years, for the sole purpose of infusing life into an inanimate body…the beauty of the dream vanished, and breathless horror and disgust filled my heart. Unable to endure the aspect of the being I had created, I rushed out of the room”.
4
Two definitions of AI:
“The use of computer programs and programming techniques to cast light on the principles of intelligence in general and human thought in particular.
--Margaret Boden
“The science of making machines do things that would require intelligence if done by humans.”
-Marvin Minsky
BOTH OF THESE STATEMENTS ORIGINATE IN ALAN TURING’S FIRST COMPUTER SCIENCE ARTICLE
Working assumption: all cognition is computable
Question:
Is what’s not yet known to be computable actually computable?
if so, then what?
if not, why not, and what does that tell us about cognition?
7
Who was Alan Turing?
B. 1912 London, attended King’s College, Cambridge and Princeton University. He studied mathematics and logic (he hadn’t invented computer science yet)
At 23, he invented the “Turing machine” and published “On Computable Numbers in 1936, the first and most important paper in comp. sci.
During WWII, solved the German Enigma code by use of electromechanical devices—a precursor to the computer
Laid the foundation for major subfields of comp sci: theory of computation, design of hardware and software, and the study of artificial intelligence
“The Imitation Game,”
aka
“The Turing Test”
In 1950, Turing posited a way to test machine intelligence: a person in a room before a screen. S/he would correspond with two agents and based on their responses, decide which was a machine and which was human. If the machine can pass fo.
Agree or disagree with, and discuss the following statement Corp.docxoreo10
Agree or disagree with, and discuss the following statement: "Corporate intelligence is not corporate espionage because 95 percent of the information a company needs to make strategic decisions is available and accessible to the public." Explain your rationale.
Your response should be at least 200 words in length. All sources used, including the textbook, must be referenced; paraphrased and quoted material must have accompanying citations.
David, F. (2011). 1.
Strategic management: concepts & cases
(Custom Edition ed., pp. 72-74). New York: McGraw-Hill Irwin.
No Wiki, Dictionary.com or Plagiarism
.
After watching Reactions to an Impending Death Sentence and Ti.docxoreo10
After watching
Reactions to an Impending Death Sentence
and
Ties That Bind
, discuss the impact of our various relationships with those who are dying on how death impacts us. For example, how would you relate to a dying child, adult or older adult when they are dying? How would you relate to those left behind: parents, siblings, children, grandchildren, spouse? How do you feel about your own death? Discuss these questions in 250 – 300 words
.
How to Make a Field Mandatory in Odoo 17Celine George
In Odoo, making a field required can be done through both Python code and XML views. When you set the required attribute to True in Python code, it makes the field required across all views where it's used. Conversely, when you set the required attribute in XML views, it makes the field required only in the context of that particular view.
Exploiting Artificial Intelligence for Empowering Researchers and Faculty, In...Dr. Vinod Kumar Kanvaria
Exploiting Artificial Intelligence for Empowering Researchers and Faculty,
International FDP on Fundamentals of Research in Social Sciences
at Integral University, Lucknow, 06.06.2024
By Dr. Vinod Kumar Kanvaria
How to Manage Your Lost Opportunities in Odoo 17 CRMCeline George
Odoo 17 CRM allows us to track why we lose sales opportunities with "Lost Reasons." This helps analyze our sales process and identify areas for improvement. Here's how to configure lost reasons in Odoo 17 CRM
Executive Directors Chat Leveraging AI for Diversity, Equity, and InclusionTechSoup
Let’s explore the intersection of technology and equity in the final session of our DEI series. Discover how AI tools, like ChatGPT, can be used to support and enhance your nonprofit's DEI initiatives. Participants will gain insights into practical AI applications and get tips for leveraging technology to advance their DEI goals.
The simplified electron and muon model, Oscillating Spacetime: The Foundation...RitikBhardwaj56
Discover the Simplified Electron and Muon Model: A New Wave-Based Approach to Understanding Particles delves into a groundbreaking theory that presents electrons and muons as rotating soliton waves within oscillating spacetime. Geared towards students, researchers, and science buffs, this book breaks down complex ideas into simple explanations. It covers topics such as electron waves, temporal dynamics, and the implications of this model on particle physics. With clear illustrations and easy-to-follow explanations, readers will gain a new outlook on the universe's fundamental nature.
How to Add Chatter in the odoo 17 ERP ModuleCeline George
In Odoo, the chatter is like a chat tool that helps you work together on records. You can leave notes and track things, making it easier to talk with your team and partners. Inside chatter, all communication history, activity, and changes will be displayed.
This slide is special for master students (MIBS & MIFB) in UUM. Also useful for readers who are interested in the topic of contemporary Islamic banking.
Main Java[All of the Base Concepts}.docxadhitya5119
This is part 1 of my Java Learning Journey. This Contains Custom methods, classes, constructors, packages, multithreading , try- catch block, finally block and more.
A workshop hosted by the South African Journal of Science aimed at postgraduate students and early career researchers with little or no experience in writing and publishing journal articles.
This presentation includes basic of PCOS their pathology and treatment and also Ayurveda correlation of PCOS and Ayurvedic line of treatment mentioned in classics.
LAND USE LAND COVER AND NDVI OF MIRZAPUR DISTRICT, UPRAHUL
This Dissertation explores the particular circumstances of Mirzapur, a region located in the
core of India. Mirzapur, with its varied terrains and abundant biodiversity, offers an optimal
environment for investigating the changes in vegetation cover dynamics. Our study utilizes
advanced technologies such as GIS (Geographic Information Systems) and Remote sensing to
analyze the transformations that have taken place over the course of a decade.
The complex relationship between human activities and the environment has been the focus
of extensive research and worry. As the global community grapples with swift urbanization,
population expansion, and economic progress, the effects on natural ecosystems are becoming
more evident. A crucial element of this impact is the alteration of vegetation cover, which plays a
significant role in maintaining the ecological equilibrium of our planet.Land serves as the foundation for all human activities and provides the necessary materials for
these activities. As the most crucial natural resource, its utilization by humans results in different
'Land uses,' which are determined by both human activities and the physical characteristics of the
land.
The utilization of land is impacted by human needs and environmental factors. In countries
like India, rapid population growth and the emphasis on extensive resource exploitation can lead
to significant land degradation, adversely affecting the region's land cover.
Therefore, human intervention has significantly influenced land use patterns over many
centuries, evolving its structure over time and space. In the present era, these changes have
accelerated due to factors such as agriculture and urbanization. Information regarding land use and
cover is essential for various planning and management tasks related to the Earth's surface,
providing crucial environmental data for scientific, resource management, policy purposes, and
diverse human activities.
Accurate understanding of land use and cover is imperative for the development planning
of any area. Consequently, a wide range of professionals, including earth system scientists, land
and water managers, and urban planners, are interested in obtaining data on land use and cover
changes, conversion trends, and other related patterns. The spatial dimensions of land use and
cover support policymakers and scientists in making well-informed decisions, as alterations in
these patterns indicate shifts in economic and social conditions. Monitoring such changes with the
help of Advanced technologies like Remote Sensing and Geographic Information Systems is
crucial for coordinated efforts across different administrative levels. Advanced technologies like
Remote Sensing and Geographic Information Systems
9
Changes in vegetation cover refer to variations in the distribution, composition, and overall
structure of plant communities across different temporal and spatial scales. These changes can
occur natural.
RPMS TEMPLATE FOR SCHOOL YEAR 2023-2024 FOR TEACHER 1 TO TEACHER 3
The Future of NursingLeading Change, Advancing HealthAdv.docx
1. The Future of Nursing
Leading Change, Advancing Health
Advising the nation/Improving health
For more information visit www.iom.edu/nursing
Report Recommendations
1 RepoRT ReCommeNdATIoNs
Key messages
Nurses should practice to the full extent of their education and
training.•
Nurses should achieve higher levels of education and training
through an •
improved education system that promotes seamless academic
progression.
Nurses should be full partners, with physicians and other health
care professionals, •
in redesigning health care in the United States.
Effective workforce planning and policy making require better
data collection •
and an improved information infrastructure.
Recommendations
2. Recommendation 1: Remove scope-of-practice barriers.
Advanced practice registered
nurses should be able to practice to the full extent of their
education and training. To achieve this goal,
the committee recommends the following actions.
For the Congress:
• Expand the Medicare program to include
coverage of advanced practice registered nurse
services that are within the scope of practice
under applicablestate law, just as physician
services are now covered.
• Amend the Medicare program to authorize
advanced practice registered nurses to perform
admission assessments, as well as certification of
patients for home health care services and
for admission to hospice and skilled nursing
facilities.
• Extend the increase in Medicaid reimbursement
rates for primary care physicians included
in the ACA to advanced practice registered nurses
providing similar primary care services.
• Limit federal funding for nursing education
programs to only those programs in states
that
have adopted the National Council of StateBoards of
Nursing Model Nursing Practice Act
and Model Nursing Administrative Rules (Article
XVIII, Chapter 18).
For state legislatures:
3. • Reform scope-of-practice regulations to
conform to the National Council of State Boards
of Nursing Model Nursing Practice Act and Model
Nursing Administrative Rules (Article
XVIII, Chapter 18).
• Require third-party payers that participate in
fee-for-service payment arrangements to pro-
vide direct reimbursement to advanced practice
registered nurses who are practicing within
their scope of practice under state law.
2 THe FuTuRe oF NuRsINg
For the Centers for Medicare and Medicaid Services:
• Amend or clarify the requirements for
hospital participation in the Medicare program to
ensure that advanced practice registered nurses are
eligible for clinical privileges, admitting
privileges, and membership on medical staff.
For the Office of Personnel Management:
• Require insurers participating in the Federal
Employees Health Benefits Program to include
coverage of those services of advanced practice
registered nurses that are within their scope
of practice under applicablestate law.
For the Federal Trade Commission and the Antitrust Division of
4. the Department of Justice:
• Review existing and proposed state regulations
concerning advanced practice registered
nurses to identify those that have anticompetitive
effects without contributing to the health
and safety of the public. States with unduly
restrictive regulations should be urged to
amend
them to allow advanced practice registered nurses to
provide care to patients in all circum-
stances in which they are qualified to do so.
Recommendation 2: expand opportunities for nurses to lead and
diffuse collabora-
tive improvement efforts. Private and public funders, health
care organizations, nursing educa-
tion programs, and nursing associations should expand
opportunities for nurses to lead and manage
collaborative efforts with physicians and other members of the
health care team to conduct research
and to redesign and improve practice environments and health
systems. These entities should also
provide opportunities for nurses to diffuse successful practices.
To this end:
• The Center for Medicare and Medicaid Innovation
should support the development and
evaluation of models of payment and care
delivery that use nurses in an expanded and
lead-
ership capacity to improve health outcomes and
reduce costs. Performance measures should
be developed and implemented expeditiously where
best practices are evident to reflect the
5. contributions of nurses and ensure better-quality
care.
• Private and public funders should collaborate,
and when possible pool funds, to advance
research on models of care and innovative
solutions, including technology, that will enable
nurses to contribute to improved health and health
care.
• Health care organizations should support and
help nurses in taking the lead in developing
and adopting innovative, patient-centered care models.
• Health care organizations should engage nurses
and other front-line staff to work with
developers and manufacturers in the design,
development, purchase, implementation, and
evaluation of medical and health devices and
health information technology products.
3 RepoRT ReCommeNdATIoNs
• Nursing education programs and nursing associations
should provide entrepreneurial pro-
fessional development that will enable nurses to
initiate programs and businesses that will
contribute to improved health and health care.
Recommendation 3: Implement nurse residency programs. State
boards of nursing,
accrediting bodies, the federal government, and health care
organizations should take actions to sup-
6. port nurses’ completion of a transition-to-practice program
(nurse residency) after they have com-
pleted a prelicensure or advanced practice degree program or
when they are transitioning into new
clinical practice areas.
The following actions should be taken to
implement and support nurse residency
programs:
• State boards of nursing, in collaboration
with accrediting bodies such as the Joint
Commis-
sion and the Community Health Accreditation
Program, should support nurses’ completion
of a residency program after they have completeda
prelicensure or advanced practice degree
program or when they are transitioning into new
clinical practice areas.
• The Secretary of Health and Human Services
should redirect all graduate medical education
funding from diploma nursing programs to support
the implementation of nurse residency
programs in rural and critical access areas.
• Health care organizations, the Health Resources
and Services Administration and Centers
for Medicare and Medicaid Services, and philanthropic
organizations should fund the devel-
opment and implementation of nurse residency
programs across all practice settings.
• Health care organizations that offer nurse
residency programs and foundations should evalu-
ate the effectiveness of the residency programs in
7. improvingthe retention of nurses, expand-
ing competencies, and improvingpatient outcomes.
Recommendation 4: Increase the proportion of nurses with a
baccalaureate degree
to 80 percent by 2020. Academic nurse leaders across all
schools of nursing should work together
to increase the proportion of nurses with a baccalaureate degree
from 50 to 80 percent by 2020. These
leaders should partner with education accrediting bodies,
private and public funders, and employers to
ensure funding, monitor progress, and increase the diversity of
students to create a workforce prepared
to meet the demands of diverse populations across the lifespan.
• The Commission on Collegiate Nursing
Education, working in collaboration with the
National League for Nursing Accrediting Commission,
should require all nursing schools to
offer defined academic pathways, beyond articulation
agreements, that promote seamless
access for nurses to higher levels of
education.
• Health care organizations should encourage nurses
with associate’s and diploma degrees to
enterbaccalaureate nursing programs within 5 years
of graduation by offering tuition reim-
bursement, creating a culture that fosters
continuing education, and providing a salary
dif-
ferential and promotion.
4 THe FuTuRe oF NuRsINg
8. • Private and public funders should collaborate,
and when possible pool funds, to expand
bac-
calaureate programs to enroll more students by
offering scholarships and loan forgiveness,
hiring more faculty, expandingclinical instruction
through new clinical partnerships, and
using technology to augment instruction. These
efforts should take into consideration strate-
gies to increase the diversity of the nursing
workforce in terms of race/ethnicity, gender,
and
geographic distribution.
• The U.S. Secretary of Education, otherfederal
agencies including the Health Resources and
Services Administration, and state and private funders
should expand loans and grants for
second-degree nursing students.
• Schools of nursing, in collaboration with other
health professional schools, should design
and implement early and continuous
interprofessional collaboration through joint class-
roomand clinical training opportunities.
• Academic nurse leaders should partner
with health care organizations, leaders from primary
and secondary school systems, and othercommunity
organizations to recruit and advance
diverse nursing students.
Recommendation 5: double the number of nurses with a
doctorate by 2020. Schools
9. of nursing, with support from private and public funders,
academic administrators and university
trustees, and accrediting bodies, should double the number of
nurses with a doctorate by 2020 to add
to the cadre of nurse faculty and researchers, with attention to
increasing diversity.
• The Commission on Collegiate Nursing
Education and the National League for Nursing
Accrediting Commission should monitor the
progress of each accreditednursing school to
ensure that at least 10 percent of all
baccalaureate graduates matriculate into a
master’s or
doctoral program within 5 years of graduation.
• Private and public funders, including the Health
Resources and Services Administration and
the Department of Labor, should expand funding
for programs offering accelerated graduate
degrees for nurses to increase the production of
master’s and doctoral nurse graduates and
to increase the diversity of nurse faculty and
researchers.
• Academic administrators and university trustees
should create salary and benefit packages
that are market competitive to recruit and retain
highly qualified academic and clinical nurse
faculty.
5 RepoRT ReCommeNdATIoNs
10. Recommendation 6: ensure that nurses engage in lifelong
learning. Accrediting bod-
ies, schools of nursing, health care organizations, and
continuing competency educators from multiple
health professions should collaborate to ensure that nurses and
nursing students and faculty continue
their education and engage in lifelong learning to gain the
competencies needed to provide care for
diverse populations across the lifespan.
• Faculty should partner with health care
organizations to develop and prioritize competen-
cies so curricula can be updated regularly to ensure
that graduates at all levels are prepared
to meet the current and future health needs of
the population.
• The Commission on Collegiate Nursing
Education and the National League for Nursing
Accrediting Commission should require that all
nursing students demonstrate a compre-
hensive set of clinical performance competencies
that encompass the knowledge and skills
needed to provide care across settings and the
lifespan.
• Academic administrators should require all
faculty to participate in continuing profes-
sional development and to perform with cutting-edge
competence in practice, teaching, and
research.
• All health care organizations and schools of
nursing should foster a culture of lifelong
learn-
ing and provide resources for interprofessional
11. continuing competency programs.
• Health care organizations and otherorganizations
that offer continuing competency pro-
grams should regularly evaluate their programs for
adaptability, flexibility, accessibility, and
impact on clinical outcomes and update the
programs accordingly.
Recommendation 7: prepare and enable nurses to lead change to
advance health.
Nurses, nursing education programs, and nursing associations
should prepare the nursing workforce
to assume leadership positions across all levels, while public,
private, and governmental health care
decision makers should ensure that leadership positions are
available to and filled by nurses.
• Nurses should take responsibility for their
personal and professional growth by continuing
their education and seeking opportunities to develop
and exercise their leadershipskills.
• Nursing associations should provide leadership
development, mentoring programs, and
opportunities to lead for all their members.
• Nursing education programs should integrate
leadership theory and business practices
across the curriculum, including clinical practice.
• Public, private, and governmental health care
decision makers at every level should include
representation from nursing on boards, on executive
12. management teams, and in otherkey
leadershippositions.
6 THe FuTuRe oF NuRsINg
Recommendation 8: Build an infrastructure for the collection
and analysis of inter-
professional health care workforce data. The National Health
Care Workforce Commission,
with oversight from the Government Accountability Office and
the Health Resources and Services
Administration, should lead a collaborative effort to improve
research and the collection and analysis
of data on health care workforce requirements. The Workforce
Commission and the Health Resources
and Services Administration should collaborate with state
licensing boards, state nursing workforce
centers, and the Department of Labor in this effort to ensure
that the data are timely and publicly
accessible.
• The Workforce Commission and the Health
Resources and Services Administration should
coordinate with state licensing boards, including those
for nursing, medicine, dentistry, and
pharmacy,to develop and promulgate a standardized
minimum data set across states and
professions that can be used to assess health
care workforce needs by demographics, num-
bers, skill mix, and geographic distribution.
• The Workforce Commission and the Health
Resources and Services Administration should
set standards for the collection of the minimum data
13. set by state licensing boards; oversee,
coordinate, and house the data; and make the
data publicly accessible.
• The Workforce Commission and the Health
Resources and Services Administration should
retain, but bolster, the Health Resources and
Services Administration’s registered nurse
sample survey by increasingthe sample size, fielding
the survey every otheryear, expanding
the data collected on advanced practice registered nurses,
and releasing survey results more
quickly.
• The Workforce Commission and the Health
Resources and Services Administration should
establish a monitoring system that uses the most
current analytic approaches and data from
the minimum data set to systematically measure and
project nursing workforce require-
ments by role, skill mix, region, and demographics.
• The Workforce Commission and the Health
Resources and Services Administration should
coordinate workforce research efforts with the
Department of Labor, state and regional edu-
cators, employers, and state nursing workforce centers
to identify regional health care work-
forceneeds, and establish regional targets and plans
for appropriately increasingthe supply
of health professionals.
• The Government Accountability Office should
ensure that the Workforce Commission mem-
bership includes adequate nursing expertise.
14. 7 CommITTee LIsT
Committee on the Robert Wood Johnson Foundation Initiative
on
the Future of Nursing, at the Institute of medicine
Donna E. Shalala (Chair)
President, University of Miami, Coral Gables,
FL
Linda Burnes Bolton (Vice Chair)
Vice President and Chief Nursing Officer, Cedars-Sinai
Health System and Research Institute, Los
Angeles, CA
Michael R. Bleich
Deanand Dr. Carol A. Lindeman Distinguished
Professor, Vice Provost for Inter-professional Edu-
cation and Development, Oregon Health & Science
University School of Nursing, Portland
Troyen A. Brennan
Executive Vice President, Chief Medical Officer, CVS
Caremark,Woonsocket, RI
Robert E. Campbell
Vice Chairman (retired), Johnson & Johnson, New
Brunswick, NJ
Leah Devlin
Professor of the Practice, University of North
Carolina at Chapel Hill School of Public
Health,
Raleigh
15. Catherine Dower
Associate Director of Research, Center for the Health
Professions, University of California, San
Francisco
Rosa Gonzalez-Guarda
Assistant Professor, School of Nursing and Health
Studies, University of Miami, Coral Gables,
FL
David C. Goodman
Professor of Pediatrics and of Health Policy, and
Director, Center for Health Policy Research,
The
Dartmouth Institute for Health Policy and
Clinical Practice, Hanover, NH
Jennie Chin Hansen
Chief Executive Officer, American Geriatrics Society,
New York
C. Martin Harris
Chief Information Officer, Cleveland Clinic, OH
8 THe FuTuRe oF NuRsINg
Anjli Aurora Hinman
Certified Nurse-Midwife, Intown Midwifery,
Atlanta, GA
William D. Novelli
Distinguished Professor, McDonough School of
Business, Georgetown University, Washington,
16. DC
Liana Orsolini-Hain
Nursing Instructor, City College of San Francisco,
CA
Yolanda Partida
Director, National Center, Hablamos Juntos, and
Assistant Adjunct Professor, Center for Medical
Education and Research, University of California,
San Francisco, Fresno
Robert D. Reischauer
President, The Urban Institute, Washington, DC
John W. Rowe
Professor, Mailman School of Public Health,
Department of Health Policy and Management,
Columbia University, New York
Bruce C. Vladeck
Senior Advisor, Nexera Consulting, New York
The Institute of medicine serves as adviser to the nation to
improve health.
Established in 1970 as the health arm of the National Academy
of Sciences,
the Institute of Medicine is a nonprofit organization that works
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and the public.
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