IOM Future of Nursing Report Recommendations
Each of a the eight report recommendations are listed below with a brief descriptin. Recommendation titles link to more detailed information on the Future of Nursing website. Below each recommendation is the California Action Coalition actions.

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.

California Action Coalition

  • Conduct a gap analysis to compare the IOM Future of Nursing for nursing scope-of-practice recommendations to the laws and statutes of California for the registered nurse and the four advanced-practice registered nurse roles.
  • Conduct a gap analysis to compare California advanced-practice nurse scope-of-practice regulations to the National Council of State Boards of Nursing Consensus Model for Advanced-Practice Registered Nurse Regulation.


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.

California Action Coalition

  • Convene a statewide symposium in September 2012 to explore opportunities to transform health-care delivery in California, share current innovative models, and assess gaps in current models of care delivery.


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 practice areas.  

California Action Coalition

  • Expand programs for new graduates to include more community-based opportunities.
  • Create a statewide evaluation of current programs to inform next steps.


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 2020. 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.

California Action Coalition

  • Establish baseline percentage of currently practicing registered nurses with minimum educational level of B.S.N. in California to enable setting realistic 80 percent by 2020 goal.
  • Inventory and analyze data from existing California A.D.N.-to-B.S.N projects to establish best practices and define technical assistance needs.
  • Continue to facilitate progress on Assembly Bill 1295 with consultation and support to the California Community College and California State University Chancellor’s Offices.


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.

California Action Coalition

  • Work with Recommendation #8 co-leads to establish baseline number of nurses with a doctorate.
  • Establish outcome measures and methods of collecting that data for reaching the goal of a 10 percent increase of B.S.N. graduates matriculating into master’s-degree programs within five years.


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 nurses and 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.

California Action Coalition

  • Work closely with Recommendations #4 and #5 workgroups to establish priorities and communications plans for messaging to multiple audiences (such as nurses, hospitals, community health) regarding the need for culture change to expectations of life-long learning in the profession of nursing.
  • Create a repository on the California Action Coalition website showcasing service and education partnerships that demonstrate effective models for fostering and supporting lifelong learning.


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.

California Action Coalition

  • Conduct gap analysis of 2011 statewide leadership survey to identify needs for developing new leadership programs for nurses. Current programs found in the survey to be available to nurses throughout the state will be posted to the California Action Coalition website.
  • Expand nursing leadership opportunities by providing training opportunities for participation in boardrooms, policy discussions and management teams.
  • Develop a systematic plan for involving students in the coalition work.


Recommendation 8: Build an infrastructure for the collection and 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 workforce 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.

California Action Coalition

  • Upload all public-access web links and resources for data to the California Action Coalition website.
  • Disseminate a seamless inventory of statewide data for purposes of analysis and workforce planning.
  • Work closely with other recommendation workgroups to assess what data needs would help implement their strategies.