Understanding the 8 IOM Recommendations

In 2010, the Institute of Medicine (IOM), known as the National Academy of Medicine (NAM) since 2015, released a report titled The Future of Nursing: Leading Change, Advancing Health. One of the IOM recommendations called for at least 80 percent of nurses to obtain a Bachelor of Science in Nursing (BSN) by 2020. Besides requiring higher education for nurses, the IOM made seven other recommendations for healthcare.

The Eight IOM Recommendations

While focus remains on nurses earning a BSN, the other IOM recommendations are also important for advancing healthcare, which is patient-centered and supports best nursing practices for successful health outcomes. Here are the eight IOM recommendations:

  1. Remove scope-of-practice barriers for nurses.
  2. Expand opportunities for nurses to lead and collaborate.
  3. Implement residency programs for nurses.
  4. Increase the number of nurses with a baccalaureate degree by 2020.
  5. Double the amount of nurses with a doctorate by 2020.
  6. Promote lifelong learning for nurses.
  7. Prepare and enable nurses to become health leaders.
  8. Collect and analyze nursing workforce data.

Clearing the Way for Nurses to Practice

Because advanced practice registered nurses (APRN) have the education and preparation to carry out many of the same duties as physicians, they should be able to provide care to patients without encountering any professional barriers. Federal and state legislation that recognizes the role of APRNs can make this possible.

Medicare needs to include coverage for advanced practice RNs and extend the same reimbursement rates for their services as they do for physicians. Nurses should be allowed to perform admission assessments, determine home healthcare for patients and decide when hospice or placement in a nursing facility is necessary.

Leaders and Collaborators

Nursing education programs and associations should help nurses pursue leadership roles. When nurses act as leaders, they can reduce costs and improve health outcomes.

Nurses are an invaluable source of information regarding patient care, which is why it is essential for nurses to collaborate with other healthcare professionals. They can instruct personnel about concerns, conduct research and advise patients about care options. Nurses have the knowledge and experience to inform developers and manufacturers of medical and health products about what devices and technology would enhance their nursing practice.

Nurse Residency for Transitioning

A nurse residency program eases the transition from an academic environment to a healthcare institution. By participating in a nurse residency program, nurse leaders monitor and guided other nurses.

The IOM suggests that all graduate medical education funding should go toward nurse residency programs in rural regions and places deemed critical instead of investing in diploma nursing programs.

BSN and Doctorate Degrees for Nurses

The IOM maintains that nurses with baccalaureate and doctorate degrees are qualified and prepared to administer the best patient care. All nursing schools should offer easy-to-navigate academic pathways like online RN to BSN programs.

Academic nurse leaders need to work together to increase the number of nurses who graduate with a BSN and attract nursing students from diverse backgrounds to meet the needs of an ethnically mixed population.

Programs should encourage at least 10 percent of nurses with a BSN to enter a master’s or doctoral degree program within five years of earning a baccalaureate degree. Nurses with graduate degrees are needed to fill nurse faculty and research positions.

Continuing Education for Nurses

Nurses who engage in lifelong learning acquire the competencies they need to provide medical care to patients that span from infancy to old age. Academic faculty and healthcare organizations need to form initiatives to upgrade curriculum that addresses new procedures, technologies and policies that affect healthcare. Further, continuing competency programs must stay adaptable, flexible and accessible to working nurses.

Health Leaders

Nursing education programs should prepare nurses for leadership positions. These programs need to include curriculum that combines leadership theory and business practices in a clinical setting. Nursing associations can help nurses by offering leadership development and mentoring as well as directing them to leadership opportunities in their practices.

Nurses and Workforce Data

The Workforce Commission and the Health Resources and Services Administration, along with state nursing licensing boards, should gather data to measure and project nursing workforce requirements and ensure that the information remains up-to-date and available to the public. Furthermore, the data can help assess the needs of the healthcare workforce based on the following:

  • Demographics.
  • Numbers.
  • Skill mix.
  • Geographic distribution.

Meeting the IOM 2010 Goals

After the publication of the IOM report, the Robert Wood Johnson Foundation (RWJF) and the American Association of Retired Persons (AARP) introduced the Future of Nursing Campaign for Action (the Campaign) to follow the progress of implementing the recommendations.

The campaign has found that the complexity of the current healthcare system requires collaboration and nurses along with other healthcare professionals still need improvement in these areas:

  • Healthcare delivery.
  • Scope of practice.
  • Education.
  • Collaboration.
  • Leadership.
  • Diversity in nursing profession.
  • Workforce data.

Even though some progress has been made at the federal and state levels, barriers still exist that prohibit the expansion of APRN scope of practice. Additionally, healthcare professionals need to stay committed to building relationships that foster efficient and exceptional patient care. More nurses are necessary in leadership positions in healthcare systems, insurance companies, government agencies and on advisory committees because they can be instrumental in reforming patient care and payment systems.

Nurses in leadership roles can advocate for changes in the healthcare system, translate research to use in practice and contribute their expertise about healthcare delivery. The IOM recommendations uphold the prominent role of the nursing profession in transforming the healthcare system so that all patients receive affordable quality care.

Learn more about the CSUSM online RN to BSN program.


Retrieved from Assessing Progress on the Institute of Medicine Report The Future of Nursing. (2015, December). National Academies of Sciences, Engineering, and Medicine: Report in Brief: Assessing Progress on the Institute of Medicine Report The Future of Nursing

Retrieved from Focus On: The Future of Nursing. (n.d.). Lippincott NursingCenter: Focus On: The Future of Nursing

Retrieved from Free Summary The Future of Nursing: Leading Change, Advancing Health. (n.d.). Foundation for Nursing Excellence: The Future of Nursing: Leading Change, Advancing Health (Free Summary)

Retrieved from The Future of Nursing Focus on Education. (2010, October). Institute of Medicine of the National Academies: The Future of Nursing: Focus on Education

Retrieved from The Future of Nursing Leading Change, Advancing Health Report Recommendations. (n.d.). Institute of Medicine: The Future of Nursing Report Recommendations

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