tice regulations, nursing research methods and data analysis, and health policy. In such cases, the committee called upon the foremost experts in those fields to serve as consultants and advisors during its deliberations (see the acknowledgments section of the report for a list of these individuals). In addition, the committee benefited from resources made available through the unique partnership between the IOM and RWJF, which allowed for borrowed-staff agreements that provided the committee with additional expertise from RWJF on nursing, nursing research, and communications. This partnership also facilitated the availability of additional information resources that were provided through AARP’s Center for Championing Nursing in America and AcademyHealth.

LITERATURE REVIEW

Over the course of the study, the committee received and reviewed a wide range of literature from a variety of sources that was relevant to all aspects of its charge. Staff monitored key developments related to nursing, including newly published literature and legislative activity on both on the federal and state levels, with input from the Center to Champion Nursing in America, the NRN (described below), and GYMR public relations. Each committee meeting and public forum provided an opportunity for distinguished experts to submit articles and reports relevant to their presentations. Finally, committee members and the public were invited to submit articles and reports that would further support the committee’s work. In total, the committee’s database of relevant documents included almost 400 articles and reports.

Nursing is a frequently studied profession. Since the 1923 release of the Goldmark Report, funded by the Rockefeller Foundation, hundreds of public and private commissions and task forces have examined many facets of the profession, including its education system, diversity, scope of practice, workforce capacity, and relationship to other health professions and the public (Goldmark, 1923). The primary driver for this interest in the profession is nurses’ essential role in caring for the sick and supporting the well. A number of factors affect the implementation of recommendations contained in previous reports, such as the exclusion of nurses from their production; the failure of the profession itself, through a lack of either resources or political will, to act on the recommendations; or the failure to redirect the focus from nurses to what is necessary to improve patient care. Additional factors, such as context, time, and place, also influence the success of a study and the implementation of its recommendations.

Since 1997, the IOM has produced at least 20 reports or workshop summaries related directly or indirectly to the nursing profession. They all share at least four common themes: nurses are a critical factor in health care because they are the closest to and spend the most time with patients; nurses need the skills and knowledge to keep patients safe and help them stay healthy or recover from illness; new models of care should be developed to better utilize nurses’ skills



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