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From reducing medical errors, to increasing the quality of care, to promoting wellness, to improving efficiency and reducing costs, a new survey finds that an overwhelming majority of opinion leaders say nurses should have more influence. But these opinion leaders-including insurance, corporate, health services, government and industry thought leaders as well as university faculty-see significant barriers that prevent nurses from fully participating as leaders in health and health care. Those are key findings from a first-of-its-kind survey, Nursing Leadership from Bedside to Boardroom: Opinion Leaders' Perceptions (, conducted by Gallup on behalf of the Robert Wood Johnson Foundation. Gallup interviewed 1,504 opinion leaders across key roles and industries for the survey, which was conducted August 18-October 30, 2009.


Gallup historically has found nursing ranked among the most ethical and honest professions by the nation's adults. This new survey finds that opinion leaders also view nurses as one of the most trusted sources of health information, but see nurses as having less influence on health care reform than government, insurance and pharmaceutical executives and others. Yet a strong majority of respondents say nurses should have more influence than they do now on health policy, planning and management.


"Nurses are highly trusted sources of health care information, but as we look to reform our health system, our nation is not taking advantage of all that nurses have to offer," said Risa Lavizzo-Mourey, M.D. M.B.A., president and CEO of the Robert Wood Johnson Foundation. "This survey shows that opinion leaders recognize that we are squandering opportunities to learn from nurses and implement their ideas. We must build on the widespread trust of nurses' expertise as an essential component in leading and implementing reform."


Opinion leaders identify, as major barriers to increased influence for nurses, that nurses are not perceived as important decision makers or revenue generators compared with doctors, and do not have a single voice on national issues.Opinion leaders rank nurses behind six other stakeholders when it comes to influencing health reform over the next 5-10 years. "It is obvious that nurses have the expertise, experience, knowledge and skills necessary to improve health care delivery and the health of individuals," said Reed V. Tuckson, M.D., F.A.C.P., executive vice president and chief of medical affairs for UnitedHealth Group. "Every day, I see nurses exercise their clinical judgment and leadership skills to make important and much-needed changes that increase access to and improve the quality and affordability of health care. Therefore, it is essential that we do more to support nurses in taking on leadership positions and ensure that they have a place and a voice at decision-making tables."


Other key findings from the new Gallup survey:


* Opinion leaders feel that nurses' primary areas of influence are reducing medical errors (51%), improving quality of care (50%), and coordinating patient care in the health care system (40%).


* Large majorities of opinion leaders said they would like to see nurses have more influence in a large number of areas, including reducing medical errors and improving patient safety (90%); improving quality of care (89%); promoting wellness and expanding preventive care (86%); improving health care efficiency and reducing costs (84%); coordinating care through the health care system (83%); helping the health care system adapt to an aging population (83%); and increasing access to health care (74%).


* Seventy-five percent of opinion leaders say government officials will have a great deal of influence in health reform in the next five to ten years, compared to 56% for insurance executives, 46% for pharmaceutical executives, 46% for healthcare executives, 37% for doctors, 20% for patients and 14% for nurses.



Opinion leaders identified the top barriers to nurses' increased influence and leadership as not being perceived as important decision makers (69%) or revenue generators (68%) compared with doctors; nurses' focus on primary rather than preventive care (62%); and nursing not having a single voice in speaking on national issues (56%).


Press Release: Robert Wood Johnson Foundation, January 20, 2010