It is important to note that the reforms have broad and long-term implications for health care budgets. This is especially with the implementation of the Affordable Care Act in 2010, which was implemented to improve access to care and eliminate disparities in health care among citizens. With the implementation of the ACA, the nursing profession continues to be challenged with an overall nursing workforce shortage (Zaccagnini and Waud White, 2014). The authors noted that there is a need to support educational funding because a projected need for a 25% increase in registered nurses (Zaccagnini and Waud White, 2014). Along with a greater demand for nurses, the changing complexity of health care requires a greater number of advanced practice
