Supporting the IOM s Recommendations for the Future of Nursing

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1 EBSCO Publishing s Key Nursing Resources, CINAHL & Nursing Reference Center : Supporting the IOM s Recommendations for the Future of Nursing The 2010 The Future of Nursing: Leading Change, Advancing Health report from the Institute of Medicine (IOM) identified eight recommendations that specify how nurses should be supported, enabling them to impact the provision of affordable, quality health care. The report points out that by virtue of its numbers and adaptive capacity, the nursing profession has the potential to effect wide-reaching changes in the healthcare system. Nurses can further position themselves to lead and advance health care by using the many nursing resources from EBSCO Publishing as described below to practice evidence-based care each and every day. 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: APRNs (advanced practice registered nurses) are subject to regulatory oversight by boards of nursing in all 50 states, competency standards, and continuing education requirements. Designations recognized as advanced practice nursing include certified nurse-midwife, certified registered nurse anesthetist, clinical nurse specialist and nurse practitioner. In searching Nursing Reference Center (NRC) with CINAHL Plus with Full Text for Advanced Nursing Practice, there are over 13,000 full-text journal articles available and 293 continuing education units available that specifically relate to the four APRN designations. This content can be used to assist nurses with their research as they complete their advanced practice certification. Advanced practice registered nurses can use the many continuing education units to maintain their licensure as well. Nursing Reference Center is an evidence-based resource that will assist nurses as they continue to evolve their education, training, and knowledge. Recommendation 2: Expand opportunities for nurses to lead and diffuse collaborative improvement efforts Private and public funders, health care organizations, nursing education 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. As the provider of the CINAHL (the Cumulative Index of Nursing and Allied Health Literature) databases, the most comprehensive resource for nursing and allied health literature, and Nursing Reference Center, the first true evidence-based point-of-care resource for nurses, EBSCO Publishing uniquely provides health care organizations with much-needed information resources supporting research, education, and patient-centered care. Using the CINAHL database, nurses can search the nursing and allied health literature for original research (e.g., randomized controlled trials, etc.) and secondary sources (e.g., systematic reviews, etc.) to identify best practice. The database contains indexing for over 3,200 journal titles, as well as full text for more than 770 titles, providing a comprehensive resource for research. The evidence can be incorporated into competencies, policies, and procedures to improve practice.

2 Nursing Reference Center provides nurses with the opportunity to participate in professional development, and enables them to improve their leadership capabilities. Over 800 continuing education modules allow nurses to learn about areas of nursing care they might not cover in their own area of practice. Management papers, such as Conflict Management, Teambuilding, and Delegating Authority, can be referenced to assist new head nurses, supervisors, and managers in taking on additional responsibilities and collaborating with other members of the health care team. These resources can be shared among departmental folders for use by all staff nurses in daily practice, through journal club, or individual learning as desired. Through EBSCO Publishing s 7-step evidence-based methodology, the evidence from databases such as CINAHL is selected, evaluated, appraised and synthesized into Nursing Reference Center content, which directly supports practice recommendations. For example, the evidence-based care sheet, Catheter-Related Bloodstream Infections (CRBSIs): Guidelines for Prevention, identifies and synthesizes the latest relevant guidelines for infection prevention. The database is current and updated daily. By utilizing and embedding the latest evidence from Nursing Reference Center s nursing practice and skill papers into practice within the organization, nurses can ensure they provide evidence-based care within their health care systems. More broadly, EBSCO Publishing is a provider of a suite of evidence-based resources to support not only nursing, but also clinical allied health, rehabilitation, and patient education needs covering the continuum of care. The suite of content is developed under an integrated editorial process, shared among a number of editorial teams. Recommendation 3: Implement nurse residency programs State boards of nursing, accrediting bodies, the federal government, and health care organizations should take actions to support nurses completion of a transition-to-practice program (nurse residency) after they have completed a prelicensure or advanced practice degree program, or when they are transitioning into new clinical areas. Over 800 nursing skills and their competency checklists in Nursing Reference Center can be used within the scope of a nursing residency program to support and evaluate learning through these programs. More broadly, the entire set of content in CINAHL and Nursing Reference Center can be used across the nurse residency curriculum: i. Research articles to support critical thinking and discussion around current practices, from more than 770 full-text titles ii. Articles supporting self-evaluation of such critical skills as communication among clinicians and patients iii. Quick lessons mapped to the nursing workflow to guide nurses in developing strategies to use in practice for assessment, diagnosis, planning, implementation, and evaluation Newer nurses to the profession may expect to access key information on the go. EBSCO Publishing has provided Nursing Reference Center available via iphone and ipad to meet this need.

3 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 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. Health care organizations that provide nurses with access to CINAHL and Nursing Reference Center, and support their integration and use in the nursing workflow, create a strong learning environment that helps to encourage nurses to want to formally continue their education. The CINAHL database is used in all nursing schools to support nursing education, research, and inquiry. As nursing students learn to use the CINAHL database, they will carry forward these skills into their careers, supporting effective information-seeking in the clinical setting. Recommendation 5: Double the number of nurses with a doctorate by 2020 Schools 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 CINAHL database is consistently used by students engaged in PhD level programs in advanced nursing education. This includes not only graduate level nursing students but also allied health students globally. The nearly 3,200 actively indexed titles cover over 60 nursing disciplines, 17 allied health disciplines, and 15 other subject areas as well (e.g., Health Services Administration). Recommendation 6: Ensure that nurses engage in lifelong learning Accrediting bodies, schools of nursing, health care organizations, and continuing competency educators from multiple health professions should collaborate to ensure that 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. CINAHL and Nursing Reference Center are resources that promote nurses daily learning, in every capacity, from quickly reading up on treatment goals to completing a continuing course from home, there is content supporting a wide variety of daily practice needs. Nurses can have the ultimate confidence consulting the NRC as a trusted resource, as it is updated daily through the EBSCO editorial process. The content in CINAHL and Nursing Reference Center is available to nurses wherever they may be, whether at the nursing station, inside the organization s learning management system (LMS), electronic medical record system (EMR), or simply on the individual s mobile device (CINAHL can be accessed via the EBSCOhost mobile application and Nursing Reference Center can be accessed via the NRC iphone application). EBSCO s Cinahl Information Systems division is an accredited provider of high-quality continuing education modules. They are accredited by both IACET (International Association for Continuing Education & Training) and ANCC (American Nurses Credentialing Center).

4 Nursing Reference Center also contains a wide variety of cultural competencies, such as Obesity in a Culturally Diverse Population: an Overview, to enable nurses to gain competencies in improved patient care to a diverse population, further strengthening the quality of care and how patients perceive this care, particularly as represented through a hospital s HCAHPS survey scores. To support the provision of culturally competent care, EBSCO also provides patient education content in 15 different languages, which can be integrated into the places you need it most, including your EMR. 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 can and should take advantage of the wealth of content available from CINAHL and Nursing Reference Center, using these resources in determining and acting upon their own professional development plan, enabling them to take on leadership roles. To stay informed, nurses can set up journal alerts for their favorite titles among more than 3,200 active titles indexed in CINAHL today. Nurses can also stay abreast of key impacts of common diseases and conditions through Nursing Reference Center s evidence-based care sheets on health care costs, such as Diabetes Management: Health Care Costs. To ensure that all staff may access to this valuable content when and where it is needed most, nurse leaders should advocate and ensure that CINAHL and Nursing Reference Center are integrated into the health care organization s various systems (e.g., EMR, LMS, etc.) for ease of access. By doing the above, nurses can present themselves as informed, key leaders at the table to drive improvement in health care systems. Recommendation 8: Build an infrastructure for the collection & analysis of interprofessional 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 work force 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. Within the 3,200+ actively indexed journal titles in the CINAHL databases, EBSCO Publishing provides high-quality indexing of the literature reporting the analysis of data on health care workforce requirements, and where applicable, this data is included and referenced in Nursing Reference Center.

5 About CINAHL: CINAHL, the Cumulative Index to Nursing and Allied Health Literature, is the most comprehensive resource for nursing and allied health literature. While starting out as a single bibliographic database, CINAHL has expanded to offer four databases including two full-text versions. CINAHL is owned and operated by EBSCO Publishing, with the Cinahl Information Systems editorial team continuing to work out of the offices in Glendale, California. The CINAHL databases are available on EBSCOhost, one of the most-used research platforms available. About Nursing Reference Center: Nursing Reference Center is a comprehensive reference tool designed to provide relevant clinical resources to nurses and other health care professionals, directly at the point-of-care. This database offers staff nurses, nurse administrators, nursing students, nurse faculty and hospital librarians the best available and most recent clinical evidence from thousands of full-text documents. To learn more about EBSCO Publishing or for more information on these databases, please contact an EBSCO representative at (800) or information@ebscohost.com.