LDI/INQRI Research Brief—Nursing in a Transformed Health Care System: New Roles, New Rules Robert Wood Johnson Foundation Interdisciplinary Nursing Quality Research Initiative www.inqri.org Traditional nursing education models will need to include more online education, simulation and flipped classrooms.

LDI/INQRI Research Brief—Nursing in a Transformed Health Care System: New Roles, New Rules Robert Wood Johnson Foundation Interdisciplinary Nursing Quality Research Initiative www.inqri.org Traditional nursing education models will need to include more online education, simulation and flipped classrooms.

care settings and need to find new jobs in ambulatory and community-based settings.
Education opportunities will need to be convenient in terms of location, and financial
incentives will be required encourage nurses, and the health systems and practices that
employ them, to take time away from work to gain new skills and competencies.
One of the biggest barriers to preparing the nursing workforce is the lack of faculty and
preceptors who are familiar with the new roles demanded of nurses in new models of
care. While nurses have traditionally filled care management and coordination roles in
acute settings, the degree to which the skills and competencies acquired in acute settings
will translate into the roles nurses will fill in ambulatory settings is unclear. Educational
programs may face challenges in identifying faculty and preceptors who can teach key
skills across a variety of care settings. Educational programs also will face the challenge
of continuing role ambiguity. The redesign of health care organizations is occurring
rapidly, and many roles may be phased out while new ones emerge. Educators will need
to navigate shifting roles and adjust competencies needed according to the complexity
and diagnoses of patients and settings in which nurses will work.
Another barrier faced by educational institutions is the lack of community-based practices
in which to place nursing students. Most nurses still receive the majority of their clinical
education in inpatient settings. Yet for nurses to learn to practice in new models of care,
clinical rotations need to include exposure to high-performing teams in ambulatory
settings, and provide longitudinal experiences with patients and family caregivers.
Traditional nursing education models will need to include more online education,
simulation and flipped classrooms. An analysis of seven of the largest online RNto-BSN education programs in the U.S. found that about 21 percent of all RN-toBSN graduates came from these online programs in 2012. Many online educational
programs, both continuing education and degree programs, are highly regarded,
but more evaluations are needed to determine the quality of these approaches and
the types of knowledge best suited to simulation, online education, and flipped
classroom approaches.
New education opportunities are likely to emerge for nurses to develop skills
and knowledge specific to emerging RN roles. For example, the University of
Pennsylvania’s School of Nursing and the American Academy of Ambulatory
Care Nursing (among others) have developed certification programs to support
nurses and other health professionals in evidence-based care transitions and care
coordination. Common themes in their curricula include patient and family caregiver
engagement and education; cross-setting communication and transition; teamwork
and collaboration; patient-centered care planning; decision support and information
systems; and advocacy. This type of certification program is available to all RNs, and
some of these competencies could be incorporated into the curricula of many entrylevel RN educational programs.

Conventionally, health care systems were focused on the cure of disease instead of the prevention of disease. With today’s evolving health care changes, the shift toward effective prevention techniques is more important. The nurse’s role in preventative health care is to utilize evidence-based research and recommendations to improve the health of patients. Nurses are the catalysts for healthier lifestyles through encouragement and teaching, helping patients to potentially receive preventative services such as counseling, screenings, and precautionary procedures or medications. Nurses can impassion those to engage in healthy lifestyles through education, mentorship, and leadership.Advocating For The Nursing Role In Program Design And Implementation Essay

Encouraging Healthiness and Disease Prevention
Nurses working in various venues have a great responsibility in preventative care and wellness. The backbone of the nursing profession has always been recognized as that of a caring profession and one that excels in disease prevention and health promotion. Nurses are strong advocates for patients because they navigate the health care system.

Nurses can work formally or informally as case managers. There are formal roles for nurses as case managers where the nurse’s only role is to help patients and families navigate through the health care system. Informally, all nurses work with patients and families to make sure that they receive the holistic care that is needed for optimal outcomes. Nurses work as consultants in communities a