BOX 7-1

Research Priorities for Transforming Nursing Practice

Scope of Practice

  • Comparison of costs, quality outcomes, and access associated with a range of primary care delivery models.

  • Examination of the impact of expanding the range of providers allowed to certify patients for home health services and for admission to hospice or a skilled nursing facility.

  • Examination of the impact of expanding the range of providers allowed to perform initial hospital admitting assessments.

  • Capture of intended and unintended consequences of alternative reimbursement mechanisms for advanced practice registered nurses (APRNs), physicians, and other providers of primary care.

  • Exploration of the impact of alternative payment reform policies on the organization and effectiveness of care teams and on the role played by registered nurses (RNs), physician assistants, and APRNs on care teams.

  • Capture of the impact of health insurance exchanges on the role of APRNs in the provision of primary care in the United States.


  • Identification of the key features of residencies that result in nurses acquiring confidence and competency at a reasonable cost.

  • Analysis of the possible unintended consequences of reallocating federal, state, and/or facility budgets to support residencies and other nurse training opportunities.

to increase the quality, accessibility, and value of care through the contributions of nurses.

Implementation of the Recommendations

Each of the recommendations presented in this report is supported by a level of evidence necessary to warrant its implementation. This does not mean, however, that the evidence currently available to support the committee’s recommendations is sufficient to guide or motivate their implementation. The research priorities presented in Boxes 7-1 through 7-3 constitute key evidence gaps that need to be filled to convince key stakeholders that each recommendation is fundamental to the transformation of care delivered by nurses. For example, to be convinced to purchase equipment necessary to expand the number of nurses that can be educated using expensive new teaching technologies, such as high-fidelity

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