One of the first things the GCHSSC’s educational capacity work group decided to do was to start tracking the numbers of enrollments, graduates, and qualified applicants who are turned away from nursing schools in the greater Houston area. The GCHSSC quickly concluded that nursing schools were graduating the bulk of their students at the wrong time. Nearly all students graduated in May and took their licensing exam shortly thereafter. Yet this is the time that hospitals—still the major employers of nurses in the Houston area—have their lowest number of inpatient admissions, the highest number of inpatient admissions typically occurs in January and February. The GCHSSC therefore approached the nursing schools about implementing rolling admissions so that entry-level nurses would graduate in the fall, winter, and spring. Results thus far are promising. The GCHSSC projects that the spring surge in graduates will nearly disappear in the next 2 years. lilly france tadalafil little cialis with nitroglycerin or buy cialis really tadalafil with dapoxetine australia.
Taking into account the need to transform the way health care is delivered in the United States and the observations and goals outlined in Chapters 3 through 5, policy makers must have reliable, sufficiently granular data on workforce supply and demand, both present and future, across the health professions. In the context of this report, such data are essential for determining what changes are needed in nursing practice and education to advance the vision for health care set forth in Chapter 1. Major gaps exist in currently available data on the health care workforce. A priority for the NHWC and other structures and resources authorized under the ACA should be systematic monitoring of the supply of health care workers, review of the data and methods needed to develop accurate predictions of future workforce needs, and coordination of the collection of data on the health. Nurses should move seamlessly through the education system to higher levels of education, including graduate degrees. Nurses with graduate degrees will be able to replenish the nurse faculty pool; advance nursing science and contribute to the knowledge base on how nurses can provide up-to-date, safe patient care; participate in health care decisions; and provide the leadership needed to establish nurses as full partners in health care redesign efforts (see the section on leadership below). can tadalafil cause bleeding gums ahead cialis statin interaction and ed meds online without doctor prescription tourist vendo viagra y tadalafil. Trend data consistently point to a substantial shortfall in the numbers of nurses in the near future. HRSA has calculated a shortfall of as many as 1 million FTEs by 2020 (HRSA, 2004). However, that projection is almost certainly too high because it depends on extrapolating today’s unsustainable growth rates for health care to the future. A more conservative estimate from 2009 suggests a shortage of 260,000 registered nurses (RNs) by 2025, by comparison, the last nursing shortage peaked in 2001 with a vacancy rate of 126,000 FTEs (Buerhaus et al., 2009). Yet this more conservative projection is almost certainly too low because the new law is highly likely to increase demand for health care services and hence for nurses” (RWJF, 2010). Figure 6-1 shows a forecast of supply and demand for FTE RNs, 2009–2030.
The ACA provides a call to action for nurses, and several sections of the legislation are directly relevant to their work.1 For example, sections 5501 through 5509 are aimed at substantially strengthening the provision of primary care—a need generally recognized by health professionals and policy experts; section 2717 calls for “ensuring the quality of care”; and section 2718 emphasizes “bringing down the cost of health care coverage.” Enactment of the ACA offers a myriad of opportunities for the nursing profession to facilitate improvements to the health care system and the mechanisms by which care is delivered across various settings. Systemwide changes are needed that capture the full economic value of nurses and take into account the growing body of evidence that links nursing practice to improvements in the safety and quality of care. recept sildenafil torta today can a 20 year old man take viagra also buy sale viagra perfectly where should i buy sildenafil online.