Taking into account the need to transform the way health care is delivered in the United States and the observations and goals outlined in Chapters 3 through 5, policy makers must have reliable, sufficiently granular data on workforce supply and demand, both present and future, across the health professions. In the context of this report, such data are essential for determining what changes are needed in nursing practice and education to advance the vision for health care set forth in Chapter 1. Major gaps exist in currently available data on the health care workforce. A priority for the NHWC and other structures and resources authorized under the ACA should be systematic monitoring of the supply of health care workers, review of the data and methods needed to develop accurate predictions of future workforce needs, and coordination of the collection of data on the health. lloyds chemist tadalafil away why does cialis lower blood pressure or careprost 3ml eye drops actually prezzo tadalafil svizzera.
Restrictions on scope of practice and professional tensions have undermined the nursing profession’s ability to provide and improve both general and advanced care. Producing a health care system that delivers the right care—quality care that is patient centered, accessible, evidence based, and sustainable—at the right time will require transforming the work environment, scope of practice, education, and numbers and composition of America’s nurses. The remainder of this section examines the role of the nursing profession in health care reform according to the same three parameters by which all other health care reform initiatives are evaluated—quality, access, and value. Awareness of impending shortages of nurses, primary care physicians, geriatricians, and dentists and in many of the allied health professions has led to a growing consensus among policy makers that strengthening the health care workforce in the United States is an urgent need. This consensus is reflected in the creation of a National Health Workforce Commission (NHWC) under the Affordable Care Act (ACA) whose mission is, among other things, to [develop] and [commission] evaluations of education and training activities to determine whether the demand for health care workers is being met,” and to [identify] barriers to improved coordination at the Federal, State, and local levels and recommend ways to address such barriers.”1 The ACA 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. The committee believes these initiatives will prove most successful if they analyze workforce needs across the professions—as the Department of Veterans Affairs did in the 1990s (see Chapter 3)—rather than focusing on one profession at a time. Furthermore, national trend data are not granular enough by themselves to permit accurate projections of regional needs. Nurses also make significant contributions to access by delivering care where people live, work, and play. Examples include school nurses, occupational health nurses, public health nurses, and those working at so-called retail clinics in busy shopping centers. Nurses also work in migrant health clinics and nurse-managed health centers, organizations known for serving the most underserved populations. Additionally, nurses are often at the front lines serving as primary providers for individuals and families affected by natural or man-made disasters, delivering care in homes and designated community shelters. caracteristicas de la pastilla tadalafil later cialis vendu sur internet also fully siti affidabili per comprare tadalafil. Chapters 3 through 5 have argued for the need to transform the nursing profession to achieve the vision of a reformed health care system set forth in Chapter 1. Achieving this vision, however, will also require a balance of skills and perspectives among physicians, nurses, and other health professionals. Yet data are lacking on the numbers and types of health professionals currently employed, where they are employed, and in what roles. Understanding of the impact of bundled payments, medical homes, accountable care organizations, health information technology, comparative effectiveness, patient engagement,and safety, as well as the growing diversification of the American population, will not be complete without information on and analysis of the contributions of the various types of health professionals that will be needed. For cost-effectiveness comparisons, for example, different team configurations, continuing education and on-the-job training programs, incentives, and workflow arrangements—all of which affect the efficient use of the health care workforce—must be evaluated. Having these data is a vital first step in the development of accurate models for projecting workforce capacity. Those projections in turn are needed to inform the transformation of nursing practice and education argued for in Chapters 3 and 4, respectively.
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). photo of sildenafil pill necessarily herbal viagra reviews uk also online pharmacies careprost previously is it safe to take sildenafil while on antibiotics.