In a 1,000-1,250 word paper, discuss the influence the IOM report and state-based action coalitions have had on nursing practice, nursing education, and nursing workforce development, and how they continue to advance the goals for the nursing profession.

 Role of State-Based Action Coalitions
The health care system in the US is organized in a way that every state has its unique health care regulations, laws, and programs. State-based action coalitions were developed to facilitate more participation and possession of the IOM report by the nursing practitioners, public health organization, private health organizations, and state governments. The coalitions get directives from the RWJF and the Center to Champion Nursing in America (CCNA) to enable them deliver universal health care programs in all states. The RWJF and the CCNA partner with state-based coalitions to equip them with information and campaign resources, inter-state knowledge sharing, foster communication, and provide planning tools including technical support in utilization of the tools (Gimbel et al., 2017).

Initiatives by Pennsylvania State Coalitions
The initiatives by state coalitions in Pennsylvania include endeavor to define the responsibilities of nurses in health care delivery and to create ground for full nursing practice. The coalitions also consult widely with coalitions from other states to create a standard structure of nursing course for various nursing education levels in the respective state. However, the effort to attain these objectives is compromised by various barriers including disparity in educational qualification and competency levels among nurses drawn from distinct specialties. This barrier can be addressed by encouraging and helping nurses to acquire higher education and continuous training.

Conclusion
Based on the IOM report on future of nursing, it is clear that the intention of the report is the focus on the vital relationship between nursing practice actions and the diverse population health requirements. From the recommendations of this report, nurses should strive to advance their education and engage in more training to meet the diverse needs and cover many specialty areas in nursing practice, which is crucial in delivery of superior patient-oriented health care.  Ultimately, the success of the IOM report on future of nursing will ensure reduction of health care costs and improve health care delivery.