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Over the course of the three years in
which NACNEP has reported to the Secretary
of Health and Human Services and the Congress
on its activities and recommendations
for the future it focused most directly
on the critical need to enhance patient
care quality and safety through alleviating
the pervasive nursing shortage. In the
first two years NACNEP examined the dimensions
of the nursing shortage and, in this connection,
looked broadly at those activities within
nursing education and practice that would
further the Nation's health care system
to provide quality and safe care. In the
third year NACNEP concentrated its efforts
on two areas. It participated in and reviewed
the activities implementing the legislative
approach taken by the Federal government
to assist in alleviating the nursing shortage.
NACNEP also turned its attention very
specifically to aspects of the nurse work
environment that have been shown to promote
the quality of patient care and safety
and affect the recruitment and retention
of the nurse workforce.
The conclusions and recommendations in
the first report presented a wide view
of steps that could be taken to support
the nursing education and practice arena
in working toward alleviating the nursing
shortage. In the second report, NACNEP
concentrated on presenting a review of
actions that could help to address an
underlying need in allaying the nursing
shortage, the shortage of nurse faculty.
NACNEP looked to community-wide activities,
government at all levels, the profession,
and the health care industry to effect
the changes envisioned by the cited measures.
Congress, by enacting the NRA has responded
significantly to a number of the suggested
actions. NACNEP is also mindful of the
many actions undertaken by the nursing
community, private organizations and others
in working toward effecting the necessary
changes.
Recommendations
Providing solutions to the continuing
critical nursing shortage requires continuing
cooperation from all segments. NACNEP
sees a critical leadership role for the
Federal government within these efforts
through encouraging and fostering new
creative and innovative approaches. To
this end it recommends the following six
actions designed to affect the nursing
education, practice and work environment
leading to improved access to and quality
of the Nation's delivery of health care
to its disparate population:
- Broaden the impact of the Nurse Reinvestment
Act initiatives by increasing the funding
appropriations, consistent with national
demand, to further improvements in nursing
practice and education and the retention
of the nurse workforce.
- Expand the resources available to
develop models that will effectively
recruit and graduate sufficient numbers
of racial/ethnic students to reflect
the Nation's diverse population.
- Building on the five years of work,
beginning with the joint COGME/NACNEP
activities on fostering health professions
interdisciplinary practice and education
in patient safety and cultural competence,
support continuing efforts through the
implementation of the recommendations
arising out of the IOM summit as outlined
in Health Professions Education: A Bridge
to Quality.
- Create a positive environment for
enhancing the recruitment and retention
of the nurse workforce by fostering
the development of working conditions
that provide for the involvement of
nurses in the operation and patient
care decision-making at the unit level,
the participation of nurse executives
in the employment setting's top decision-making
body and the promotion of programs to
actively incorporate a diverse workforce
at all levels of the organization.
- Support the development and evaluation
of culturally competent interventions
that lead to reductions in gaps contributing
to disparities and show improved quality
of care in very diverse nurse/patient
environments through demonstration projects
in one or more nursing specialties using
cooperative agreements.
- Develop a regular, periodic, survey
mechanism to create a database on the
elements of the nurse work environment
through establishing cooperative agreements
with professional hospital-affiliated
organizations.
Future Activities
As NACNEP moves forward with its examination
of the issues relating to the nurse workforce
it will continue to monitor the availability
of an appropriate nurse supply necessary
to provide quality health care for the
Nation's population. It will in its examination
of the state of nursing education and
practice look toward changes that might
lead to improved recruitment from all
segments of the population and enhanced
retention of the nurse workforce. In its
consideration of measures that might strengthen
the provision of nursing care to the Nation's
population, NACNEP will examine the outcomes
that have been accomplished through support
of the NRA and other aspects of Title
VIII and suggest ways of building on these.
It will also continue its particular focus
on interdisciplinary education and practice
on the improvement of patient safety,
the influence on the recruitment and retention
of nurses and the effects on educational
costs through an examination of the results
of the medicine and nursing divisions'
jointly sponsored cooperative agreements
described in NACNEP's second report.
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