Overview of the Report
This report is organized into three parts. Part I presents the report’s key messages and important contextual information for the study. Chapter 1 offers the committee’s vision for health care in the United States, explains why nurses have an essential role in realizing this vision and why a fundamental transformation of the nursing profession is needed if they are to fulfill this role, and details four key messages that structure the discussion and recommendations in Parts II and III. As context for the remainder of the report, Chapter 2 describes how the U.S. health care system is evolving and sets forth principles the committee believes should guide that evolution.
Part II details the fundamental transformation of the nursing profession that is needed to achieve the improved health care system described in Chapter 1. This transformation needs to occur in three broad areas: practice (Chapter 3), education (Chapter 4), and leadership (Chapter 5). This part of the report also addresses the crucial need for better data on the health care workforce to inform this transformation and that of the overall health care system (Chapter 6).
Chapters 2 through 6 include a series of case studies and profiles illustrating the work of nurses and innovative models that either were developed by nurses or feature nurses in a leadership role. These case studies and profiles not only provide texture to the report but also offer real-life examples of nurses working in reconceptualized roles and directly affecting the quality, accessibility, and value of health care. Cumulatively, these case studies and profiles offer a glimpse into what the future of nursing could be.
In addition, the report includes 10 appendixes. Appendix A describes the study
methods and information sources used to inform the committee’s deliberations; Appendix B contains biographical sketches of the committee members; Appendix C offers highlights from the three public forums held by the committee on the future of nursing in the areas of acute care, care in the community, and education; Appendix D contains the consensus model for advanced practice registered nurse (APRN) regulation that is referenced in Chapter 3 and in recommendation 1 in Chapter 7; and Appendix E provides a brief description of undergraduate nursing education in the United States. Appendixes F–J are not printed in this report but can be found on the CD-ROM in the back of this book and contain papers commissioned by the committee on the following topics: matching nursing practice and skills to future needs; transformational models of nursing across different care settings; federal options for maximizing the value of APRNs in providing quality, cost-effective health care; the future of nursing education; and international models of nursing.