Implementing the FON Recommendations February 2013

Implementing the
Future of Nursing
• Describe how to become involved in efforts to advance the
Future of Nursing
• Develop grassroots methods for spreading the Campaign
for Action at participant’s organization
• Demonstrate increased awareness of current and planned
initiatives to support the nursing and its impact on the
Health of Texans
IOM Reports
Health Care Reform-Affordable Care Act
Primary Care Shortages
Value-Based Purchasing
Increased focus on Research and Evidence-based
• National Initiatives on Quality and Safety
• Care Coordination
1. Remove scope of practice barriers.
2. Expand opportunities to lead collaborative improvement
3. Implement nurse residency programs.
4. Increase the proportion of nurses with BSN to 80% by 2020.
5. Double the number of nurses with doctorate degrees by
6. Ensure that nurses engage in life-long learning.
7. Prepare nurses to lead change.
8. Build an infrastructure for the collection and analysis of
workforce data.
• Frontline Staff-What’s in it for me?
– Over 500 page report from nurses-over 2 years of work
– Transform Care Delivery
– Platform that supports nursing’s commitment to Patient
• Coalition Efforts-Website updates
• Staff Newsletters
• Ties to Strategic Initiatives-Vision
• Staff Forums and Community Presentations
Engage and support recommendations for RWJF/IOM Future of Nursing
Remove Scope of Practice Barriers
• Advance use of CNS-driven, population-focused programs, e.g. Stroke and Trauma Certifications
• Expand role of Unit Secretaries to Health Unit Coordinators
Nurses to lead and diffuse collaborative improvement efforts
• Continue to improve nurse-to-physician relations as evidenced by increased
collaboration/participation of physicians on key house wide initiatives
• Open and sustain advances in throughput with a Clinical Decision Unit
Bridge the gap from academia and practice
• Build and sustain a mentoring program for new graduates based on Professional Practice Model
and Magnet® Model
Increase BSN rate to 80% house wide by 2015
Engage and support recommendations for RWJF/IOM Future of Nursing
Prepare nurses to lead change
• Advance number of certified nurses to 50%
Double the number of doctorate prepared nurse
Embrace Evidence-Based Practice and Research
Each unit will engage in 1 EBP/Research Study
Enhance a culture of excellence by achieving key performance milestones that
affect quality and safety
Nurse sensitive metrics will continually improve and outperform national
• Fall prevention program promoting efforts to exceed NDNQI 25th percentile for number of falls per
1000 patient days
• Sustain and/decrease current rate of HAPU, CAUTI, CLBSI
• Advanced Practice Nurses
– Perryman Report fully supports the IOM stance that APN
increase access, safety and continuity of care
– Average cost of NP visit is 20-35% lower than the average cost of
a physician office visit (MEPS)
– No difference in malpractice rates among states
• National Council of State Boards of Nursing
• Examining Our Practice-Remember it’s not just APNs…
– What you or your colleagues doing that does not require
your RN skill set?
– What you or your colleagues not doing that we are great at
• Care Coordination
• Working with State and Federal Regulatory bodies
– National Council of State Boards of Nursing
• Transition to Practice
– Texas Medical Association
– Peers In Practice
• Great Work Being Done!
– California Study of Regulations
– RWJF-Transforming Care at the Bedside
• Ways to Expand
Health Care Policy-Duty
Customer Service-Advocacy
Education or Academic Partnerships
• Meeting the Challenge to Improve the Care
– Our ethical code requires it-Provision 8 “the nurse collaborates…”
– Engaging those with similar goals
Transforming Care at the Bedside
Community Transition Programs
Medical Services/Ambulances
• IHI Triple AIM
– Decrease Cost
– Increase Satisfaction or the “patient experience”
– Improve the overall health of the population
• Community partnerships-Community Health Action Team
• HCAHPS questions
• Care Coordination/Transition of Care
– Clinical Nurse Leader
• Partnership-Avoid “acute care centric”
– Social Services, Pharmacists, Physicians, Home Care, LTC
• Not just a “product you purchase”
– Advantages of formalized program
• Data/recruiting
• Not Just About Student Placement
– Henry Street Project-Public Health
• It’s a Partnership!
– AACN/AONE Guiding Principles for Practice-Academic Partnerships
Develop Formal Relationships
– Advisory committees
– Fellowship programs to advance EBP
Shared Visions/Mutual Goals
– Dedicated Education Units
– Externships
• Why We Need
– Increase recruitment and retention
– Decrease cost for orientation and training
• Internships- “not just 15 weeks”
Journey to Professionalism
Teaching to ANA Standards of Care
ANA Code of Ethics
• Get Involved
– Preceptor/Clinical Coach
• What does this mean and why?
– Managing complexity
– Advancing EBP/Research
– Lower mortality and failure to rescue rates
• Doesn’t mean forget about the ADNs
– Pipeline for BSN enrollees
– Often best option for minorities or low-income
• Student Experience
– Clinical Placement software
– Other opportunities/Other industries
• Presbyterian Hospital of Dallas
– Strategic Vision
• Academic Partnerships
• Recruitment and Retention
• Funding and Encouragement
= Success! An increase of 12% in 1 year to 67% rate of BSNs
• Seton
– Long-term strategy with Leadership Established Guiding
• Increase BSN hire rate
• Increase Nursing retention rates
• Increase number of non-BSN nurses returning to school
Call to Action to Universities, Colleges and Hospital Systems
• The Doctor of Philosophy
– Leads Research Efforts
• The Doctor of Nursing Practice
– Translation and Promotion of Research into Practices
– Clinical Specialist
Advance Education
Certification in area of Specialty
Attend Conferences
Share locally
• TONE/TNA-Improving EHR Education-HIT
• Nurses Members of Boards-Not just hospitals
• Boardroom presentations on Micro-level changes
– Opinion Polls conducted by RWJF show many believe nurses
should have more influence on improving quality of care and
preventing errors
• Lean Methodology
• Support Shared Decision-Making
Keep Texans First
Know your power but more importantly your responsibility
Use Your Resources
Know the Issues
Get Involved
– Are you the Carrot, the egg or the coffee??
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