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Equip & Empower for Educational Transformation:Getting to 80% BSN by 2020
A Webinar for Midwestern States and Their Leaders
JULY 7, 2011
Welcome
Susan Reinhard, PhD, RN, FAAN Senior Vice President, AARP Public Policy Institute Chief Strategist, Center to Champion Nursing in America
During Today’s Webinar
• Review CCNA’s work on education • Overview of the Future of Nursing: Campaign for
Action• Transforming nursing education • Q&A• Next steps
• 30 state teams• Two national summits • Oregon site visit• State team leader convening
Susan Hassmiller, PhD, RN, FAAN, Robert Wood Johnson FoundationSenior Adviser for Nursing
Campaign Vision
• All Americans have access to high-quality, patient-centered care in a health care system where nurses contribute as essential partners in achieving success
Campaign for Action
Education
Practice
CollaborationLeadership
Data
Campaign for Action
Education
Increase to 80 percent the proportion of nurses with BSN by 2020
Double number of nurses with doctorate by 2020
Implement nurse residency programs
Promote lifelong learning
Education
• Evidence– Significant association between educational level
and patient outcomes
– 6 percent of AD grads get advanced degree, enabling them to teach and serve as PCPs, compared to 20 percent of BSN grads
Campaign for Action
• Long-term alliances• Field strategy to move key
nursing issues forward at local, state and national levels
• Expect to be in all states by end of 2012
• Capture best practices, networking
Action Coalitions
To become part of a coalition, go to: www.thefutureofnursing.org
Campaign for Action State Involvement
Map Legend
Action Coalition State
State Involvement
OR
WA
ID
MT
WY
NV
CA
UT
AZ
CO
NM
ND
SD
NE
KS
OK
TX
MN
IA
MO
AR
LA
WI
ILIN
MI
OH
KY
TN
MS AL
FL
GASC
NC
VAWV
PA
MDDE
NY
DC
CTRI
MA
VTNH
ME
AK
HI
NJ
UPDATED: 6.6.2011
Learn More by Visiting:
http://thefutureofnursing.org/
http://championnursing.org/
Like us on Facebook and join the conversation at www.facebook.com/championnursing Follow us on Twitter at www.twitter.com/championnursing.
The Case for National Nursing Workforce Data
Linda Tieman RN MN FACHEPresident, Board of Directors
National Forum of Nursing Workforce CentersRWJF Initiative on the Future of Nursing
Midwest States Best Practices Forum July 7, 2011
What we know now• The National Sample Nursing Study, done every 4
years, probably will not be repeated
• The National Healthcare Workforce Data Center is funded
• The national Forum of Nursing Workforce Centers developed, vetted and gained endorsement for nursing minimum datasets
What else do we know about nursing workforce data today?
• It’s inconsistent across the states in content, frequency, analytic approach and reporting
• States have the most accurate and current data on their respective nursing workforce IF they are collecting, analyzing and reporting
• We have no ability to compare or contrast across states, to aggregate data for groups or regions of states, or to make accurate projections relative to new roles
So what?• Legislators and other key decision makers do
not have accurate, reliable, valid, current data on which to base resource allocation decisions impacting the nursing workforce
• Nurses are accountable to lead the work related to our nursing workforce
• Nursing is vulnerable to decisions that are not in the best interest of students, practicing nurses, educators or patients
Supply-what we could know with a National MDS
• Accurate profiles of nurses by work location, roles, demographics, level of educational preparation, compensation, benefits.
• Satisfaction with career, needs/wants for support, education
• The experience of newly-graduated RN’s• Approaches that are successful in recruitment
and retention• Best practices in nursing care delivery
• Knowledge, skills, abilities (KSA) required of nurses in new roles and changing current roles in all settings
• Best practices in addressing KSA for the incumbent nursing workforce
• Numbers needed as delivery models change• Locations where nurses are needed• With healthcare reform, what opportunities are
identified for nurses to improve care and access and reduce costs
Demand-what we could know with a National MDS
• Best practices in educational redesign• Successes in enriching the diversity of nursing
student and nursing faculty populations• Successes in recruiting and retaining faculty in
all settings• Best practices in trans-disciplinary education• What students’ think of their education and
what they’d advise us
Education-what we could know with a National MDS
The Nursing Minimum Data Sets• Supply-how many nurses are available to the
workforce, at what levels of preparation?• Demand-how many nurses are needed in the
workforce as we look to the future?• Education-how many nurses are being
educated and at what levels of preparation?• www.nursingworkforccenters.org, Minimum
Data Sets• OR, your own state nursing workforce center
Questions
Aligning Education and Practice
Donna L Boland PhD., RN, ANEFAssociate Professor and Associate Dean for
EvaluationCo-Chair Indiana Action Coalition
Midwest Region Webinar Preparing the future Indiana Nursing Workforce
Interviewed 29 chief nursing administrative officers Convenient sample but represent all aspects of the state Majority of respondents represented acute care settings Minority of respondents had primary responsibility for outpatient
settings
Study Purpose Impact of health care reform on health care Identification of nursing roles based on perceived reform impact Identification of competencies nurses will need to meet role
revisions Potential partnerships that will prepare novice nurses to assume
role
Major FindingsImplications for Education
Paradigm Shift from Sickness to Health
Need for different educational orientation that focuses on health
Different knowledge related to prevention, families, holistic approaches to health, health coaching, understanding behaviors-what motivates actions
Communication skills, motivational interviewing, stress and coping, group and family dynamics
Significant shift in employment settings from in-hospital to out of hospital settings
Being able to understand and manage the gap among care settings Less emphasis on educating for “sick care” in illness focused settings Decrease emphasis on tasks and increase emphasis on managing
care needs (“managed care on steroids”)
Major Implications for Education Increasing Care Complexity
Complexity in Acute Care Settings More technology driving need for increasing skills
(“technology smart”) Increasing responsibility for “nurse sensitive outcomes” or
non-reimbursable outcomes Increasing skills in care coordination, delegation,
coordinating interprofessional teams Practice in a rich evidence-based setting Emphasis on pathophysiology, pathogenesis, genetics,
complex assessment skills “learn thinking” = maximum use of time and effort Prioritization of work
Major Implications for Education Complexity in Non Acute Settings
Ability to work in more autonomous settings Care management skills especially across care settings Communication—communication—communication skills Managing chronic health issues in an accountable care environment Focus on prevention, end of life care, health
assessment/monitoring skills, promoting self-efficacy skills, health literacy, ethics, economics
Better able to access and coordinate community resources including health, economics, social services, political systems
Development of a “service mentality” (being service oriented) Increase education skills—focus on promoting and sustaining
behavioral change across a continuum of care settings
Implications for Changes in Role Preparation of BSN Prepared Nurses
Care Coordinator Care Coach/Nurse Navigator Interprofessional /Multidisciplinary Team Leader Care Manager
SKILLS/COMPETENCIES System thinker (looking at the big picture-more holistic) Controller of the environment to promote “healing” Responsible for patient satisfaction and care outcomes/paid for
performance Succession planning Understanding the impact of health care reform on care Nursing visibility Practice to full extent of education and license Safety and quality improvement as a way of life
Implications for Tomorrow’s Education System
Registered nurses need to be baccalaureate prepared
Challenge in rural areas but needing to build bridges to transition to this educational level of preparation---concern for rigor
LPN role very limited in acute care—more in long term care
Nurses need to be better prepared to assume evolving roles
Partnerships between education and practice to assume responsibility for transition to practice (residency) opportunities that are not specific to institution or educational program
Implications for Tomorrow’s Education System
Drivers for New Models for Education and Practice
Focus more on systems thinking—critical thinking as it relates to “understanding inter-relationships”, priorities, “holistic health care” across a continuum of care setting and providers, management of systems
Focus on the idea of interdisciplinary practice and the role of nurses within interprofessional health care teams/breaking down “silos”
Need to prepare nurses for roles and positions outside acute care settings—community, tela-health medicine, involving technology roles,
Increase skills in prevention, health maintenance and end-of-life care Increase use of simulations as systems having difficulty supporting
educational requests/needs Consumerism mentality Increasing acuity in acute care settings
Policy strategies to support 80% BSN:Michigan’s Story
Teresa Wehrwein PhD, RN, NEA-BCAssociate Dean for Academic and
Clinical AffairsJuly 7, 2011
Overview • State government led strategies • Healthcare system action• Academic policy discussions
State Taskforces• Developed to take action on issues raised
in the 2005 Nursing Agenda • Commissioned by the Director of the
Department of Community Health• Led by Chief Nurse Jeanette Klemczak
State Taskforces• Taskforce on Regulation - 2008• Taskforce on Education – 2009
– To require national accreditation for all pre-licensure programs
– To increase safety and quality preparation in programs
– To implement residency programs
State Taskforces• Taskforce on Practice -in progress
– Vision –Michigan’s nurses provide the public with safe high-quality care by practicing to the full extent of their education and competencies
– Process - Develop White Papers to support recommendations achieved by consensus
– Current activities – Conducting public forums across the state to elicit feedback and working in teams on identified issues
Legislation in process• House Bill 4496• Authorizes Community Colleges to award some
baccalaureate degrees including BSN• Pros and cons for enacting the legislation
http://www.legislature.mi.gov/(S(yfkgwz45miwzlffy1stcgu55))/mileg.aspx?page=getObject&objectName=2011-HB-4496
Health system policy initiatives• Earning the BSN in 10• Initial discussions at joint taskforce of the
statewide leadership groups (3M) • Michigan Organization of Nurse Executives
Position Paper • Munson Health System – implementation
example
Academic policy initiatives• Seamless transition – moving toward joint
enrollment– Positioning students to begin University
studies while in ADN program– Transfer student status– Financial aid implications
Expanding Faculty Capacity in Nursing: Non-
traditional Nurse Educators as Online
TeachersSusan Taft, PhD, MSN, RNKent State University College
of NursingContact: staft@kent.edu; 216-
595-9011
Part of the National Partners Investing in Nursing*
Program
Funding provided by 4 foundations:•Robert Wood Johnson Foundation
(lead)•Northwest Health Foundation
(national)•Cleveland Foundation (local)
•Mt. Sinai Health Care Foundation (local)
(MSHCF funded Phase 1 to develop curriculum)
Project runs Sept. 1, 2010-Aug. 31, 2012
*Partners Investing in Nursing’s Future (PIN) is a partnership of the Northwest Health Foundation
and the Robert Wood Johnson Foundation to support the capacity, involvement and leadership
of local foundations to advance the nursing profession in their own communities.
MissionIncrease Nursing Educational
Capacity Access a new and previously
unrecognized source of nursing faculty, NTNEs*, to supplement and expand educational capacity in U.S. colleges of nursing, and
To prepare the NTNEs to deliver high-quality online education part-time to collegiate nursing students.
*NTNEs: non-traditional nurse educators
Non-traditional Nurse Educators
Defined as masters-prepared* nurses working outside of academe who would like to teach part-time; includes nurses working in clinical roles, retired or approaching retirement, engaged in family responsibilities, and/or physically disabled.
*Masters degree may be in any discipline
NTNEs are being recruited and trained by TNEs – traditional nurse educators – current partners are 1 national and 4 NE Ohio Colleges of Nursing: -Kent State University -Cleveland State University -Ursuline College -University of Akron
-St. Joseph’s College of Maine
To be cascaded across the U.S. Seeking partners!
Project stages
Project Stages Phase 1: Pilot Course, Methods of
Online Education June-July 2009 Phase 2: Curriculum Development 3-credit hour graduate course
developed Phase 3: Train the Trainers, Spring
2011, Methods of Online Education course delivered to 12 participating TNEs from 5 schools of nursing;
certified by Quality Matters
Project stages – cont.Phase 4: Developing NTNEs, Spring 2012TNEs recruiting masters-level NTNEs & TNEs for course. First graduates: May 2012. Continue in cycles in future. Strong response and interest from NTNEs, many available.Phase 5: Establish database of NTNEs, beginning fall 2012 and ongoing. Database is a resource for universities to select part-time faculty for online courses.
Seeking University Partners for …1. Participating TNEs to teach their own Methods course at
their universities
2. Referral of local, state, or national NTNEs to learn online education
3. Hiring of NTNE graduates to teach online courses
Questions
Next Steps
• Webinar and materials: www.championnursing.org/events• A resource under development. Will highlight both the
national and state perspectives on getting to 80% by 2020 • Learning Collaboratives to convene state and national
leaders to continue to share best practices around education.