Presentation to the VHA CNO Council

Report
The Future of Nursing in Indiana
ISNA Policy 101 Conference
November 7, 2014
Kimberly Harper, RN, MS
Chief Executive Officer, Indiana Center for Nursing
Nursing Co-Lead, Indiana Action Coalition – National Future of Nursing
Campaign for Action
Indiana Center for Nursing (ICN) Vision
• The ICN shall serve as a unified voice for the
profession of nursing in Indiana to:
• Assure a highly qualified nursing workforce
prepared to meet the demand of a dynamic
healthcare system
• Promote Indiana as a destination state for
nursing practice
ICN Member
Combined Schools
and Hospitals/
Health Systems
ICN Statewide
Organizational
Members
ICN Strategic Priority Areas
•
•
•
•
•
•
One Voice, One Center for Nursing in Indiana
Designing Indiana Nursing’s Future
Building Indiana Nursing Workforce Infrastructure
Nursing Scholarships and Tuition Reimbursement
Education - Practice Partnerships
Increasing Diversity in Nursing to Reflect the
Population of Indiana
The Institute of Medicine Report
IOM Recommendations
• Remove scope of practice barriers
• Expand opportunities for nurses to lead and
diffuse collaborative improvement efforts
• Implement nurse residency programs
• Increase proportion of nurses with BSN degree
to 80 percent by 2020
IOM Recommendations (cont.)
• Double the number of nurses with a doctorate
by 2020
• Ensure that nurses engage in lifelong learning
• Prepare and enable nurses to lead change to
advance health
• Build an infrastructure to collect and analyze
health care workforce data
Action Coalitions Created
Collaboration funded by the Robert Wood Johnson and
AARP Foundations to ensure that all Americans have
access to high quality, patient-centered care
Action Coalitions in All States
Indiana Action Coalition
(INAC)
• Partnership between Indiana Center for Nursing
(ICN) and Indiana Area Health Education
Centers (IN AHEC) state-wide to achieve the
Indiana goals related to the recommendations of
the Institute of Medicine Report on the Future of
Nursing
IOM Recommendation 1
Remove scope-of-practice barriers.
Advanced practice registered nurses
should be able to practice to the full extent
of their education and training.
National and State Initiatives
• Many states moving legislatively toward
statute changes – some successful, some
not
• Veterans Affairs working to initiate changes
in the Handbook allowing autonomous
practice across the US
• Indiana Access to Care Discussion Group
• Scope of Practice Workgroup
IOM Recommendation 2
Expand opportunities for nurses to lead and
diffuse collaborative improvement efforts.
Private and public funders, health care
organizations, nursing education programs,
and nursing associations should expand
opportunities for nurses to lead and manage
collaborative efforts with physicians and other
members of the health care team to conduct
research and to redesign and improve practice
environments and health systems.
Promising Practices are Increasing
• All across the US nurses are utilizing nursing
research and evidence based practice to
change current practice resulting in
improved patient outcomes
• More healthcare organizations nationwide
are supporting nurses in their research
• Indiana healthcare employers and schools of
nursing are participating in more and more
research
• Nurse managed clinics are increasing across
the state
IOM Recommendation 3
Implement nurse residency programs.
State boards of nursing, accrediting bodies, the
federal government, and health care
organizations should take actions to support
nurses’ completion of a transition-to-practice
program (nurse residency) after they have
completed a prelicensure or advanced practice
degree program or when they are transitioning
into new clinical practice areas.
You Did It!
Preparation for Practice
• Residency Programs are springing up all
over the nation
• Evidence demonstrates they are successful
• Residency Programs are NOT the same as
Orientation Programs
• Several exist already in Indiana
• The ICN has a subcommittee of the Practice
Committee dedicated to the creation of a
web-based toolkit for Nurse Residency
Programs
IOM Recommendation 4
Increase the proportion of nurses with a
baccalaureate degree to 80 percent by 2020.
Academic nurse leaders across all schools of
nursing should work together to increase the
proportion of nurses with a baccalaureate
degree from 50 to 80 percent by 2020. These
leaders should partner with…(cont.)
IOM Recommendation 4 (cont.)
Increase the proportion of nurses with a
baccalaureate degree to 80 percent by 2020.
…education accrediting bodies, private and
public funders, and employers to ensure
funding, monitor progress, and increase the
diversity of students to create a workforce
prepared to meet the demands of diverse
populations across the lifespan.
WOW! Really?
The American Nurse July/August 2012
Strategies to Reach 80/20
• National focus by the CCNA to provide
support for Academic Progression through
specified options
• Schools across Indiana and throughout the
US are working to create seamless
progression at all levels
• Community Colleges are partnering with
State Universities to adopt affiliation
agreements allowing for ease of transition
• ICN Education Committee has accomplished
a number of initiatives toward this end
Strategies to Reach 80/20 (cont.)
• Indiana is currently at 49% of RNs educated
at the BSN level or higher
• Many of our Indiana hospitals are either only
hiring BSN graduates or looking at
preferential hiring for those with BSN
degrees and requiring RNs who do not have
a BSN to achieve that within a specified
period of time
• Scholarship opportunities are available
through many employers, the ICN, etc.
IOM Recommendation 5
Double the number of nurses with a doctorate
by 2020.
Schools of nursing, with support from private
and public funders, academic administrators
and university trustees, and accrediting bodies,
should double the number of nurses with a
doctorate by 2020 to add to the cadre of nurse
faculty and researchers, with attention to
increasing diversity.
Preparing our Future Educators and
Practice Leaders
• Nationwide, the average age of nursing
faculty is nearing 60 – that is no different in
Indiana
• Many schools have opened DNP programs
in the last few years, but the increase in PhD
programs is slow to follow
• Indiana currently has 1 PhD program and 8
DNP programs
• Scholarship opportunities are increasing
through programs such as the ICN and
Spotlight on Nursing
IOM Recommendation 6
Ensure that nurses engage in lifelong learning.
Accrediting bodies, schools of nursing, health
care organizations, and continuing
competency educators from multiple health
professions should collaborate to ensure that
nurses and nursing students and faculty
continue their education and engage in lifelong
learning to gain the competencies needed to
provide care for diverse populations across the
lifespan.
Let’s Never Stop Learning
• In addition to formal education at the
university level opportunities exist nearly
everywhere for nurses to continue learning
• Professional conferences (both in-house
and externally
• Unit-based education on various topics
• Journal clubs
• Individual nurses reading nursing research
articles while passing time on an iPad.
IOM Recommendation 7
Prepare and enable nurses to lead change to
advance health.
Nurses, nursing education programs, and
nursing associations should prepare the
nursing workforce to assume leadership
positions across all levels, while public,
private, and governmental health care
decision makers should ensure that leadership
positions are available to and filled by nurses.
Leadership Occurs at All Levels
• Nurses are increasingly being allowed to
lead changes occurring in healthcare across
the US
• Center to Champion Nursing in America
currently has a nation-wide strategy toward
Leadership and specifically placing more
well qualified nurses on boards with a goal of
placing 10,000 additional nurses on boards –
collaboration of many nursing organizations
at the national level
Leadership Occurs at All Levels (cont.)
• Indiana has many examples of nurses in
leadership roles outside of just “nursing”
tables
• ICN convened the Access to Care
Discussion Groups
• ICN is beginning a large initiative through its
Leadership Development Committee to
partner with other Indiana nursing
organizations to move this initiative forward
Are YOU
A “Leader”
In The Future Of
Nursing?
IOM Recommendation 8
Build an infrastructure for the collection and
analysis of interprofessional health care
workforce data.
The National Health Care Workforce
Commission, with oversight from the
Government Accountability Office and the
Health Resources and Services Administration,
should lead a collaborative effort to improve
research and the collection and analysis of data
on health care workforce requirements.
IOM Recommendation 8 (cont.)
Build an infrastructure for the collection and
analysis of interprofessional health care
workforce data.
…The Workforce Commission and the Health
Resources and Services Administration should
collaborate with state licensing boards, state
nursing workforce centers, and the Department
of Labor in this effort to ensure that the data are
timely and publicly accessible.
We MUST Have Data!
• The national Workforce Commission and Health
Resources and Services Administration (HRSA)
collect “some” data, which is used to predict
workforce data
• Most states collect nursing data at some level
though many do not use the data plan for the
future workforce
• Indiana has moved a long way in the last few
years to capture data regarding the nursing
workforce
Very Cute, But…Seriously?
We MUST Have Data! (cont.)
• Indiana now collects the national Minimum
Data Set (MDS) for nursing workforce in the
areas of :
• Supply
• Education
• Demand
which is/will be reported through the ICN
website as well as the sites of others
involved in the collection and analysis and
used for future planning
Soooo…What Can We Do Right Now?
• Step up to the plate!
• Get involved!
• Be heard!
• Collaborate with our partners!
• Participate in life long learning!
• Be a part of the inevitable change!
Thoughts/Comments?
Kimberly Harper, MS, RN
Chief Executive Officer
Indiana Center for Nursing
Nursing Lead
Indiana Action Coalition
National Future of Nursing Campaign for Action
kharper@ic4n.org
317-574-1325
www.IC4N.org

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