It has been more than 4 years since the Institute of Medicine (IOM) released its watershed report, The Future of Nursing: Leading Change, Advancing Health.1 The document, a collaboration between IOM and the Robert Wood Johnson Foundation (RWJF), outlined a course for nurses as the nation fully implements the Affordable Care Act and as demographics and technology change.
The report developed 4 key messages for improving health care, tapping underused nursing skills, and furthering the education of nurses in all areas of the profession:
1. Nurses should practice to the full extent of their education and training.
2. Nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression.
3. Nurses should be full partners, with physicians and other health professionals, in redesigning health care in the United States.
4. Effective workforce planning and policy making require better data collection and an improved information infrastructure.1
Immediately following the release of the Future of Nursing, the Campaign for Action, supported by RWJF and AARP, was created to promote implementation of the main proposals in the report. The campaign has encouraged state nursing organizations to identify models that address the issues and find solutions to the questions raised in the publication.
The Campaign for Action posts local success stories, keeps track of campaign progress, and provides tools and resources so that nurses can collaborate on strategies and develop plans to respond to the report's call to action.2
Here in Massachusetts, the local coalition members have been promoting state and regional strategies targeted at building a stronger and better-educated nursing work force. They have successfully achieved a number of goals: (1) gaining approval of a state Nursing Education Transfer Compact, facilitating students' ability to transfer academic credits; (2) creating options for more flexible nursing education programs to help nurses advance their education; (3) developing marketing materials to encourage nurses to advance their education; and (4) producing a toolkit for future nursing core competencies.3
INS has taken the IOM recommendations to heart, and various task forces have been "moving the needle forward" by collaborating to improve approaches to patient and health care worker safety. Each task force has a specific charge and will produce new educational solutions, if they have not already done so.
The Short Peripheral Catheter Task Force was charged with identifying, promoting, and developing recommendations and tools to improve health care provider and patient safety practices surrounding the use of short peripheral catheters. Materials completed included a position paper, the Short Peripheral Catheter Safety Checklist (both available at the INS Web site [http://www.ins1.org], in the INS Position Papers section and the Knowledge Center), the Short Peripheral Catheter card deck, and a webinar.
The Vesicant Task Force will perform a systematic literature review, focusing on the adult population, with the goal of identifying noncytotoxic infusates that meet the definition of vesicant. The Central Line Task Force will articulate INS' position on the role of the registered nurse in the insertion of nontunneled central lines.
The Unlicensed Health Care Personnel Task Force recognized that the use of unlicensed health care personnel in providing direct infusion therapies continues to expand in scope. This task force was given the assignment of reviewing current literature and surveying clinical practices in order to revise INS' 2008 position paper on the use of nursing assistive personnel in the provision of infusion therapy.
Using the IOM recommendations as a framework, INS is doing its part to strengthen nursing's position in health care. Our practice is constantly evolving with the advances in science and research. Let's continue to work together to ensure our skills and expertise are not underused. We owe it to ourselves, our profession, and our patients!
Mary Alexander, MA, RN, CRNI(R), CAE, FAAN
Mary Alexander
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