The increased demand for medical care and emerging challenges in the industry require the restructuring of some aspects of the health care delivery system. The Affordable Care Act (ACA), introduced in 2010, was a reform law aiming to enhance the nation’s health care delivery and provide a comprehensive system for fair health coverage (Mulligan & Castañeda, 2018). Under the ACA, the demand for, as well as the pressure on nurses has grown. To provide effective care, advanced education is needed to ensure appropriate training for medical personnel and positive outcomes for patients. Upon the adoption of the ACA, the country faced a shortage of nurses, followed by long working hours, lower-quality care, and higher burnout rates (Salmond & Echevarria, 2017). Hence, the changes shaped nurses’ responsibilities, placing them at the forefront of health care promotion.
As a result of changing health care system, it is crucial for nurses to understand the driving factors for the transformation and obtain the competencies required to fulfill the leading role in health care transformation. According to the United States House of Representatives (2019), “an additional 203,700 nurses will be needed every year to meet demand, filling newly created positions, and replacing retiring nurses” (Background section, para. 1). Among the recently introduced regulations, Title VIII Nursing Workforce Reauthorization Act of 2019 was introduced to improve nurses’ training, education, and practice (United States House of Representatives, 2019). It offered more opportunities for nursing personnel to adhere to current tendencies, take leading roles and increase their own well-being. Title VIII Nursing Workforce Reauthorization Act is expected to expand the range of nursing courses, increasing the number of graduates who possess advanced qualifications and are able to take up managerial responsibilities. Furthermore, the regulation aims to increase nursing workforce diversity and improve access to medical personnel in rural and underserved areas. Meeting professional standards and complying with regulations is crucial in the light of the changing health care delivery system.
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