The Action Coalition co-lead and key contacts list is updated regularly. The last update to the document was on June 11, 2025.

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Created by the Future of Nursing: Campaign for Action, the toolkit is based on the nursing process—the five steps known as ADPIE:

Assessment

Diagnosis

Planning

Implementation

Evaluation

This ADPIE framework lets health professionals assess how ready they are to take action to improve health equity locally, as well as measure their community’s needs.

Each section of the toolkit stands on its own, which means it’s user-friendly—nurses,  as well as Action Coalitions and their partners, can pick and choose elements that are appropriate for the level of engagement, experience, and the specific needs of their community.

If you have questions about the toolkit, please contact Jazmine Cooper, at jncooper@aarp.org.

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Developed in 2011, the Campaign for Action Dashboard is a series of graphs and charts the Campaign uses to evaluate its efforts to implement the recommendations in the Institute of Medicine’s The Future of Nursing: Leading Change, Advancing Health report. It contains seven primary indicators: education, doctoral degrees, state practice environment, interprofessional collaboration, leadership, workforce data, and diversity, and can be viewed by clicking the “download” button below. It was updated twice per year and was last updated in September 2021.

Data Sources

Download

Dashboard Secondary Indicators

Below are links to secondary indicator graphics that provide further support for each goal represented within the Dashboard. Data collected was for years 2010-2019.

Indicator 1: Education—Increase the proportion of nurses with a baccalaureate degree to 80 percent by 2020
Number and percent of U.S.-educated, first-time NCLEX-takers with BSN
Number of RN‐to‐BSN graduates annually
Number of hospitals in the United States with Magnet status

Indicator 2: Doctoral Degrees—Double the number of nurses with a doctorate by 2020
Total fall enrollment in nursing doctorate programs
Number of people receiving nursing doctoral degrees annually

Indicator 3: State Practice Environment—Advanced practice registered nurses should be able to practice to the full extent of their education and training
State practice environment for nurse practitioners
State practice environment for certified nurse midwives
NCSBN’s APRN Consensus Model implementation status
Number of nurse-led clinics in the United States
Number of nurse-led clinics located in medically underserved areas (MUA)

Indicator 4: Interprofessional Collaboration—Expand opportunities for nurses to lead and disseminate collaborative improvement efforts
Number of articles published in top 10 health services research journals co-authored by an RN and authors from other disciplines

Indicator 5: Leadership—Health care decision-makers should ensure leadership positions are available to and filled by nurses
Percent of hospital boards with RN members

Indicator 6: Workforce Data—Build infrastructure for collection and analysis of interprofessional health care workforce data
State boards of nursing that participate in the NCSBN Nursys Data System

Indicator 7: Diversity—Make diversity in the nursing workforce a priority
Racial/ethnic composition of the RN workforce in the United States
New RN graduates by degree type, by gender
New RN graduates by degree type, by race/ethnicity
Number of Action Coalitions with members of its’ state’s ethnic or racial minority nursing organization or of its’ men in nursing state chapter as a voting member on its most senior executive-level policy-making body
Diversity of nursing doctorate graduates by race/ethnicity
Diversity of nursing doctorate graduates by gender
States that collect race/ethnicity data about their nursing workforce (by year)
Racial and ethnic composition of RN graduates of pre-licensure nursing education programs and the general population by state – upon request

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• View the Campaign for Action Dashboard

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Nurses, nurse leaders, nurse champions and allies from across the country will virtually gather Wednesday to reflect on the profession’s achievements since the release of the 2010 Institute of Medicine report The Future of Nursing: Leading Change, Advancing Health.

More than a decade ago, that report called for nurses to seize the opportunities created by the Affordable Care Act’s expansion of access to care. It described several new capacities the profession would need to realize to achieve the goal of quality health care for all in America.

In 2021, many of those new capacities have been fully activated, while others are well on their way to becoming real. The profession can take pride in being more educated and more influential than ever before. The Future of Nursing: Campaign for Action’s dashboard indicators demonstrate this steady progress.

Yet nurses are also well aware that the dream of quality health care for all has not been realized. They are deeply concerned about new challenges like COVID-19 and old enemies like racism and misogyny. They do not want to merely congratulate themselves on their achievements, but figure out new ways to put them to work for those they serve.

A new Future of Nursing report, expected to be released this spring, will further explore these challenges. But in the meantime, Campaign experts are reflecting on the achievements described in the dashboard and what they mean to nurses now.

The Campaign is a national initiative of AARP Foundation, AARP and the Robert Wood Johnson Foundation created in 2010 to implement recommendations from the first Future of Nursing report. The Center to Champion Nursing in America, an initiative of those same organizations, runs the Campaign, which is directed by Susan B. Hassmiller, PhD, RN, FAAN, senior adviser for nursing, Robert Wood Johnson Foundation and senior scholar in residence and senior advisor on nursing to the present of the National Academy of Medicine, and Susan C. Reinhard, senior vice president and director, AARP Public Policy Institute and chief strategist for the Center to Champion Nursing in America and Family Caregiving Initiatives.

Diversity in Nursing and Health Equity

Ten years ago, more than 80 percent of the RN workforce was white, and men made up just seven percent of the RN population. The 2010 Future of Nursing report noted these demographic gaps between the nursing profession and the patients it serves. In the years since, diversifying the nursing workforce has become an increasingly important issue for the Campaign of Action as well as other health care institutions.

Kupiri Ackerman-Barger, PhD, RN, FAAN, a Campaign advisor on diversity and inclusion

The dashboard’s latest diversity numbers point to incremental progress on this front, as they have for many years. Kupiri Ackerman-Barger, PhD, RN, FAAN, is associate dean of Health Equity, Diversity and Inclusion, as well as an associate clinical professor at the University of California Davis Betty Irene Moore School of Nursing, and a Campaign advisor on diversity and inclusion. She says it is essential that the nursing profession understands this information in context. Plenty of work still has to be done to achieve a diverse nursing workforce, much less empower that workforce to realize health equity, she said.

“We see these tiny increases in diversity each year,” Ackerman-Barger said. “We are not at a standstill, we are not going backwards, but we need to understand that this is a complex, structural problem that won’t be fixed with incremental change,” she said. “At the rate we are going, it is going to be another fifty years or so before we meet the benchmark of the nursing profession matching the American population — that’s too slow.”

Ackerman-Barger takes hope from the fact that more and more people are understanding the importance of a diverse healthcare workforce — a development she says the Campaign helped bring about.

But now a new conversation needs to begin, she said. The coming decade will require greater critical thinking about the best actions to take to achieve workforce diversity. Issues of race and gender will also need to be understood with greater nuance in order to serve a more diverse population.

“Patients tend to have more satisfaction when they can receive care from someone with a background similar to themselves,” she said. “It’s also an issue of trust. Many communities don’t trust the health care system — for good reasons, historical and current. When we have representation from those communities, that engenders understanding and trust. When patients trust us, they are more likely to communicate with providers or be part of a plan for disease prevention.”

This will require innovation in data collection and program development. For example, Ackerman-Barger points out that while the nursing workforce is becoming more diverse as a whole, there is also stratification in the opportunities available for different groups. While the Campaign has successfully pushed for more baccalaureate-trained nurses, these graduates tend to be more white than the nursing population as a whole. Meanwhile, licensed vocational nurses (LVN) are disproportionately people of color.

“We have to better understand that pipeline,” she said. “It’s a matter of equity, because the LVN positions do not pay as much, they often work long hours in long-term care facilities, and they have a much harder path for career growth. I love our dashboard, but that complexity is currently missing.”

Along with colleagues from the Campaign, Ackerman-Barger recently hosted a Health Equity Action Forum that explored the opportunities and challenges for new nurses from historically underrepresented groups. She explained that looking at the issue of men in nursing can help illuminate the complex interplay of race, gender, and other factors that the profession will need to understand moving forward.

Men are still an underrepresented population in nursing. According to the dashboard, graduates of pre-licensure RN programs are 13.9 percent male, while the population of the United States is 49.2 percent male.

Yet Ackerman-Barger points out that just because men are underrepresented, this does not mean that they are underserved. In fact, there appears to be an opportunity gap in nursing similar to the ones in other fields.

“We need to have conversations about what it means to be a man in nursing and how we need to buck gender stereotypes,” Ackerman-Barger said. “But we also need to acknowledge that men in nursing tend to make more money and get hired into prestigious positions at a higher rate than women do.”

Among other subjects, participants in the Health Equity Action Forum considered how to recruit more Black men into nursing — an opportunity to significantly advance health equity, Ackerman-Barger said.

“It’s a really important conversation,” she said. “In nursing, we have a small number of men and a small number of people of color, so the number of Black men is tiny. Yet when it comes to health disparities, there are so many issues that are particular to Black men and where we need to have the perspective of Black men in talking about what is missing from our policies, research, and curricula.”

This conversation gave Ackerman-Barger hope for what the next decade of conversations about diversity in nursing could look like, she said. Plans for the future of the dashboard’s health equity metrics include adding new demographic indicators like LGBTQ status. But just as important will be understanding the greater vision for social justice this data should inform.

“One mistake people can make is thinking that any one of these things is the answer,” she said. “Doing something like recruiting more Black men into nursing won’t make health disparities go away on its own. We need to acknowledge that we are addressing racial differences in health outcomes that in some cases start as early as pre-school. So all of these efforts are just strands in the effort to fix a complicated system.”

Education and Leadership

Perhaps the most widely recognized outcome of the 2010 report was the shift to bachelor’s level education in nursing. Less than half of the RN workforce in 2010 held a bachelor’s degree. Today, it has increased to more than 59 percent. Patricia Polansky, RN, MS, director of program development and implementation for the Center to Champion Nursing in America, says that increase has led to a critical “tipping point.”

Patricia Polansky, RN, MS, director of program development and implementation for the Center to Champion Nursing in America

“Academic progression has become a formal movement in the profession,” Polansky said. “That did not exist prior to the 2010 report. All aspects of nursing became involved, and we’ve really seen lots of truly innovative ways to transform nursing education and generate more baccalaureate degree nurses.”

The emphasis on greater education has helped the profession respond to problems no one could imagine in 2010, Polansky argued.

“The committee rightly saw that the complexity of health care was increasing and we would face enormous challenges going forward, so we would need a more highly educated nursing workforce,” she said. “Obviously COVID-19 and everything else that has happened in the past year has proven that that is true.”

Doctoral education for nurses was also an important goal of the 2010 report. The dashboard shows that the profession has succeeded on this indicator more than anyone could have imagined. The report called for a doubling of doctorally trained nurses by the end of the decade. But because of the explosion in advanced practice doctorate programs, the number has increased by more than 350 percent.

Polansky said doctorally trained nurses have important contributions to make to American health care.

“Every profession needs PhDs, and we should be proud that we achieved that goal,” she said. “But we now also have doctorally prepared people in every clinical setting under the sun. That is going to make us more ambitious about policymaking and leading change. It will have an exponential impact.”

Nurses are also making a new kind of impact through service on institutions’ boards and other leadership groups. This was one of the report’s most innovative recommendations, Polansky said. She called the data on nurses’ board participation before 2010 “abysmal.”

But this year the dashboard showed that the number of nurses registered as board members and serving on other leadership groups reached more than 10,000 for the first time.

“Nurses are naturally born problem-solvers — tenacious, tireless,” Polansky said. “You see that in all kinds of clinical settings. Those are qualities that people need on boards and committees and task forces. If we had more nurses in leadership, we might not have terrible public health situations like we saw with the water in Flint, Michigan.”

The general public may not be as aware of nurses’ educational and leadership achievements as Polansky would like. But she said that in the aggregate, the past decade’s advances will help the profession stay worthy of patients’ trust.

“When patients interact with a nurse, they may not know their education level or professional training,” she said. “But they feel the competence that is required for the situation in which they need care. It all goes back to that idea of nursing as the most trusted profession, which the public has voted us year after year. Everybody knows what a nurse is, who a nurse is — it’s that person who will care for you from before you are born until the day you die.”

Access to Care

Another significant dashboard indicator focuses on how many people have access to that high-quality nursing care. The Center to Champion Nursing in America, housed at AARP, constantly has its eyes on how many states allow advanced practice registered nurses to practice to the full extent of their education and expertise. In 2020, significant progress was made in new laws passed by California, Florida and Massachusetts.

The most important change occurred at the federal level. The 2020 CARES Act allowed nurse practitioners, clinical nurse specialists, and physician assistants to certify for Medicare-supported health care. Prior to this law, APRNs’ patients had to wait for a physician to certify that home health care was required.

Winifred V. Quinn, PhD, FAANP(H) director of advocacy and consumer affairs at the Center to Champion Nursing in America

These changes will result in material improvements to patients’ lives, said Winifred V. Quinn, PhD, FAANP(H) director of advocacy and consumer affairs at the Center to Champion Nursing in America.

“From the patient experience, a delay of care could lead to unnecessary visits to the emergency room or unnecessary hospitalizations, perhaps worse,” Quinn said. “This is about you being able to get the care when and where you need it. You should be able to see your nurse practitioner and obtain all necessary care without delay during and following that visit.”

For Quinn, these improvements in California, Florida, Massachusetts and at the federal level represent an important achievement that builds upon a decade advocating for reform in access to care policies.

Yet while every change in state and federal laws is important, Quinn argued, just as significant is the narrative the Campaign constructed around these reforms.

“The access to APRN care issue is typically framed as a binary one — nurses versus physicians,” she said. “But we see it as a consumer access to care issue. When patients obtain care when and where they need it, their health is improved and family caregivers’ stress is reduced.”

This reframing helped win the support of a wide variety of stakeholders across the political spectrum, Quinn said.

“Free enterprise organizations, consumer groups, hospitals associations, insurers, and retail clinics have all supported state legislation modernizing APRN laws,” she said.

All of this work resulted in a messaging platform that helped drive advocacy in states where advocates had not previously succeeded.

The work of access to care reform will continue for years to come. Quinn is thrilled by the fact that last year’s reforms brought the total number of states with full access to care to 23. These states include 71.8 million people. The other 27 states and 257 million Americans who do not have direct access to APRN care are never far from her mind.

“Policymakers need to understand that this is an access to care issue, not a power struggle between two clinical sectors, especially when hundreds of thousands of Americans have unnecessarily died this year,” she said.

This type of thinking will also be essential in connecting the Campaign’s legislative agenda to emerging issues of health equity, many of which are expected to be highlighted in the upcoming Future of Nursing report.

“The opposition is making the argument that by modernizing APRN laws, people in underserved communities will receive second-class care,” Quinn said. “That is immoral. With the egregious health disparities that exist in the nation, we must deploy and make available every highly-skilled clinicians to ensure that all people, especially those who experience the worst disparities, receive high quality care when and where they need it.”

Dashboard data analysis by Nicole Rozko, MS, project manager at the Center to Champion Nursing in America. 

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First, a heartfelt thank you. Thank you for the contributions that we know you have made to your family, your community, the profession, and more, during a year of enormous challenges that include sickness in our ranks, burnout, grief, and worse. The pandemic has tested the world, and nursing as a whole. Even as we help others—as we always do—we also hurt.

Bearing witness to the pain and loss and the frailty of our systems continues to be hard. As the new year brings the hope of widespread availability and use of vaccines, we know that we still need to fight to heal ourselves, our fellow nurses and their families—all who continue to sacrifice.

In these earliest days of 2021, we would like to pause to look back—and forward—at nursing and the role the Future of Nursing: Campaign for Action, an initiative of AARP Foundation, AARP, and the Robert Wood Johnson Foundation (RWJF), plays in the nation’s well-being.

It was the Year of the Nurse and the Midwife, chosen to honor—200 years after her birth—the founder of modern nursing. But COVID-19 ravaged the world, which means that Florence Nightingale’s name is also now part of another sort of homage: The Nightingale Tribute names the nurses who have given their lives helping others during the worst pandemic in a century.

While the health disaster has highlighted the courage of nurses, it has also highlighted the disparities in health and health care. Then with the killing of George Floyd came a public reckoning of the effects of structural inequities, and the nation’s recognition of the need to right historical wrongs. As we affirmed at the time: Racism and injustice have no place in our country today. Our pathway to equity is to help build better health through nursing.

In ways large and small, we made strides in 2020 to do just that. Progress includes:

Access to Care

States: Through the Center to Champion Nursing in America, the Campaign’s operating arm, also an initiative of AARP Foundation, AARP and RWJF, we hosted monthly sessions to guide others on how to work with state policymakers to lift—at least during the pandemic—legal restrictions on nurses. Participants included Action Coalitions, AARP state offices, and community groups. Successes in Kentucky, Louisiana, Massachusetts, New Jersey, New York, Virginia, and Wisconsin expanded access to care for nearly 59 million people.

Florida, California, and Massachusetts also saw changes in laws that improve consumer’s access to care.

Federal: Nursing organizations including the Campaign, through AARP, helped pass the 2020 Coronavirus Aid, Relief, and Economic Security Act, providing consumers easier access to care at home.

Equity, Diversity, and Inclusion

Among contributions toward building a more diverse nursing workforce, the Campaign’s Equity, Diversity, and Inclusion Steering Committee has created a mentoring program and a health equity toolkit for use by nursing schools. The mentorship program, designed in collaboration with the U.S. Department of Health and Human Services’ Office of Minority Health and historically black colleges and universities, includes mentor-training workshops and a learning collaborative. Postponed last year, but back on track, are similar programs for students at schools that serve largely Hispanic populations, and those that serve American Indians.

Population Health in Nursing

The Campaign, with a grant from RWJF, completed a series of reports exploring promising models of nursing education related to improving population health. The Population Health in Nursing (PHIN) project, found here, also examines how nurses should be prepared for new roles in population health practice.

National Academy of Medicine report

The National Academy of Medicine (NAM) delayed to late spring 2021 its much-anticipated report on the future of nursing 2020-2030, expanded to include nursing’s role in responding to the public health crisis. Many reading this letter have contributed to the committee’s broad outreach and research, including during an August 2020 webinar.

Coming Up: Virtual Gatherings to Plan Action

The focus of each is important, so we’ll list in chronological order brief notes on the meetings we have in store for early 2021.

• On January 12, we held the first of our Health Equity Action Forums, focusing on the value of diversifying the nursing workforce to achieve health equity. It was the first of several such virtual meetings. The second, slated for February 3, will cover the topic of nursing as a career ladder for establishing financial well-being for underrepresented communities.
• February 24, we will honor the work that so many have carried out based on the 2010 Future of Nursing report. We’ll also look ahead to the next NAM report.
• In May, we expect the release of the Future of Nursing 2020-2030 report.
• June 3–4, we’ll gather Action Coalitions and other Campaign members, allies, and stakeholders to plan how to implement the new report recommendations.

Nursing Innovations Fund

Wrapping up our yearly note is a spotlight on an inspiring set of projects past and future: the Nursing Innovations Fund Awards. In October, we announced 10 ambitious projects designed to address health disparities that each earned $25,000 awards. And look for news in May about a similar funding opportunity, for projects that address structural inequities.

Again, we want to thank you for all that you have done. Nursing, long the most trusted profession, has never been more important. You have pushed through and persevered. For all you’ve endured and the grace you have shown, thank you.

Susan B. Hassmiller, PhD, RN, FAAN Senior Adviser for Nursing, Robert Wood Johnson Foundation; Director, Future of Nursing: Campaign for Action

Susan C. Reinhard, PhD, RN, FAAN Senior Vice President and Director, AARP Public Policy Institute; Chief Strategist, Center to Champion Nursing in America

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Since its beginning in 2010, The Future of Nursing: Campaign for Action has tracked progress made by its state-based Action Coalitions, nurses, and supporters as we continue to implement recommendations made by the Institute of Medicine (IOM; now the National Academy of Medicine) in its Future of Nursing: Leading Change, Advancing Health report. The Campaign established a series of more than two dozen national measures, updated twice a year and presented in a series of graphs and charts, the Dashboard. We do this, so we can regularly measure and report on progress in reaching the IOM goals.

The new numbers are in and indicate progress made in 2019 in advancing nursing education and increasing diversity in nursing. Except where noted, the data covers the years from 2010 to 2019. At the time of data collection, the number of nursing students obtaining associates degrees (ADN) was not available. Data sources are listed below.

Highlights include:

• The number of RN-to-BSN graduates annually has nearly tripled to 65,931, an increase of 193 percent.
• The number of BSN graduates from underrepresented groups more than doubled to 23,538, an increase of 104 percent. These groups include American Indian or Alaskan Native, Asian, Black or African American, Hispanic or Latino, Native Hawaiian or other Pacific Islander, plus those who identify as having two or more races. While this development is promising, we know that the diversity of the nursing workforce does not yet reflect the diversity of the communities it serves.
• The number of male BSN graduates almost doubled to 10,488, an increase of 82 percent.
• The number of entry-level masters (ELM) graduates from underrepresented groups more than tripled to 1,126, an increase of 224 percent. Those groups include American Indian or Alaskan Native, Asian, Black or African-American, Hispanic or Latino, Native Hawaiian or other Pacific Islander, plus those who identify as having two or more races.
• The number of male ELM graduates nearly tripled to 496, an increase of 171 percent.
• The number of people receiving PhD degrees annually jumped to about 800, a 51 percent increase. The number of people receiving Doctor of Nursing Practice (DNP) degrees annually grew to nearly 8,000, a 520 percent increase.
• The number of DNP graduates from underrepresented groups has grown to 2,466, an increase of more than 1,000 percent. These groups include American Indian or Alaskan Native, Asian, Black or African American, Hispanic or Latino, Native Hawaiian or other Pacific Islander, plus those who identify as having two or more races.
• The number of male DNP graduates has increased by more than nine times, to 1,043, an increase of 857 percent.
• The number of PhD graduates from underrepresented groups increased by 137 percent to 220 and the number of male PhD graduates increased by 126 percent to 79. These groups include American Indian or Alaskan Native, Asian, Black or African American, Hispanic or Latino, Native Hawaiian or other Pacific Islander, plus those who identify as having two or more races.
• The number of fall enrollments in nursing doctorate (PhD and DNP) programs increased by 249 percent, with DNP programs experiencing a more than 400 percent increase.
• As of September 14, 7,782 nurses reported their board service to the Nurses on Boards Coalition, an increase of 9.6 percent since January 20, 2020, when there were 7,100 nurses reporting.
• The number of articles published co-authored by an RN that appeared in top health services journals increased by 16 percent.

Below are a few highlights dating from 2011 to 2020:

• The state boards of nursing that participate in the National Council of State Boards of Nursing (NCSBN) Nursys Licensure Quick Confirm data system increased by nearly 19 percent.
• The number of U.S. hospitals with magnet status increased by 118, an increase of 30 percent.

For more information, view the primary Dashboard indicators (which cover progress in seven areas identified in the IOM report) and the secondary Dashboard indicators (which provide further support measures for each primary Dashboard goal). Working with our state-based action coalitions, nurses, and supports, the Campaign is paving the way toward the stronger, better-prepared, and more diverse nursing workforce that our nation needs.

Dashboard Data Sources

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