Top 5 nursing issues for 2013

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Alexandra Wilson Pecci, for HealthLeaders Media, January 8, 2013.

I unabashedly love Christmas (I've been known to sneak in holiday tunes before Thanksgiving). But I also love the days after Christmas when I get to take down the tree, reorganize my house, make a list of New Year's resolutions, and get a fresh start on everything from work to working out.

There's something so refreshing about a brand new year and all that it brings, from clean calendar pages to wondering about what the months ahead will hold for us.

For nurse leaders, certain issues, from increasing education to reducing readmissions, will undoubtedly be front and center this year. Here's a look at some of the top issues that will capture our focus in 2013:

1. The ever-expanding role of APRNs
The final rule on physician fees for 2013 allows Medicare to pay Certified Registered Nurse Anesthetists for services to the full extent of their state scope of practice. And in many states, APRNs have been fighting for—and winning—autonomy.

But expect the battle to continue into 2013 and beyond; in fact, ANA president Karen Daley tells me via email that it's among the organization's top issues for 2013. "Advanced practice registered nurses in many states still face regulatory barriers preventing them from practicing to their full scope," she said. "These barriers should be removed throughout the country."

2. The rise of care coordination and the "medical extensivist"
The term medical extensivist caught my eye when it showed up in the top 13 healthcare buzzwords for 2013. According to the article, the medical extensivist is a clinician, such as an advance practice nurse, who extends their scope of practice outside the hospital and into home or other settings.

These professionals aim to help people with chronic illness keep patients healthier outside the hospital. The idea is that regular, routine patient visits could help keep patients out of the emergency room and hospital, ultimately reducing readmissions, keeping patients healthier, and saving money. The term might be a relatively new one, but the movement is one that nurses have been leading for years.

And with a new Medicare rule that will pay nurses when they help patients make the successful transition from hospitals to other settings, look for possible job creation, too.

3. Extending the culture of safety to nurses
That professional caregivers are often poorly cared for themselves is one of the great ironies of nursing. But nurses need to be safe themselves in order to properly care for patients.

Issues range from ensuring a work environment where nurses are safe from violence and abuse to encouraging nurses to make healthy lifestyle choices and get enough sleep.

Among the top issues for the ANA this year is safe patient handling in an effort to prevent musculoskeletal disorders that can come with lifting patients.

"Currently, ANA is leading the development of national interdisciplinary safe patient handling standards to help hospitals and other health care employers develop safe, effective, and enduring programs," ANA president Karen Daley tells HealthLeaders via email. "Standards are expected to be released in spring 2013."

4. Continuing to advance nurse education
The year 2013 brings us one year closer to the goal set by the Institute of Medicine's Future of Nursing report that calls for increasing the proportion of nurses with a baccalaureate degree to 80% by 2020.

That, coupled with evidence that increasing the number of nurses with specialty certifications can lead to better patient care, will certainly lead to more nurses expanding their educations.

Look for an increasing number of innovative programs to help nurses do this, such as portfolio credentialing alternatives.

5. Quality, quality, quality
What do the four issues above have in common? They all aim to improve healthcare quality in some way. In fact, in the 2012 HealthLeaders Industry Survey's Nurse Leaders Report, nurse leaders cited patient experience and satisfaction and clinical quality and safety as their organization's top two priorities for the next three years. 

According to the survey, 72% of nurse leaders rank patient experience and satisfaction among their top three priorities; 55% said the same about clinical quality and safety.

Source: HealthLeaders Media