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.