PROBABLE FUTURE TRENDS IN HEALTH CARE, NURSING PRACTICE AND NURSING EDUCATION CIRCA 2000; A DELPHI APPLICATION

The purpose of this study was to investigate and report the predictions of a selected group of hospital nursing service administrators about future developments in health care, nursing practice, and nursing education. Another purpose of the study was to identify, based on these predictions, future competencies for nursing graduates that will be required for professional practice in 2000 and to relate those competencies to needed characteristics of nursing education. One hundred and forty one hospital nursing service administrators representing five midwestern states participated in the study. Ninety eight individuals completed the total three round Delphi study. The following questions were investigated: (1) What events will most probably occur in health care by 2000? (2) What events will most probably occur in nursing practice by 2000? (3) What events will most probably occur in nursing education by 2000? (4) What additional competencies will most probably be required of professional nursing graduates by 2000? (5) What learning activities would prepare graduates in these competencies? (6) What are the characteristics of role change that will occur in professional nursing graduates by 2000? Predictions concerning the probable future of health care, nursing practice, nursing education, graduate competencies and role change characteristics were systematically secured utilizing the Delphi process. Individual responses were tabulated according to median and interquartile percents of probability. The findings included but were not limited to: Widespread use of incentives by health care agencies; inclusion of health maintenance and hospice care in hospital services; demand for health counselors; initiation of National Health Insurance; focus on health education; development of uniform job descriptions for nurses; utilization of computers by nurses for decision making; movement to baccalaureate nursing education; increase in joint appointments; increase in faculty-student ratio; and use of computerized clinical simulations. Predictions for future graduate competencies included: Knowledge of the elderly; discharge planning; use of high-tech equipment; knowledge of economic issues; autonomy in decision making; and possession of management skills