Forces and Factors, Issues and Influencers: Knowledge Nurses Need to Lead. Mark Majek Director, Operations Texas Board of Nursing

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1 Forces and Factors, Issues and Influencers: Knowledge Nurses Need to Lead Mark Majek Director, Operations Texas Board of Nursing September 18, 2014

2 E-NOTIFY ---

3 National News! Tri-Regulator Collaborative! Nursing, Pharmacy and Medicine! Telehealth! Healthcare Compacts! Nursing Workforce! Nursing Education IOM Report! Distance Education! Advanced Practice Registered Nurses Consensus! NCSBN Research! Transition to Practice! Simulation Study

4 Military Update! Military Veterans Seeking Careers in Nursing! College Credit for Heroes Program! LVN to ADN! Medic to ADN! Medic to BSN! BON Website Military Section

5 Emerging State Issues! Pill Mills! Pill mill is a term used primarily by local and state investigators to describe a doctor, APRN clinic or pharmacy that is prescribing or dispensing powerful narcotics inappropriately or for non-therapeutic reasons.! They often open and shut down quickly in order to evade law enforcement.! Although the problem is nationwide, Drug Enforcement Administration officials believe the highest concentration of pill mills are in Florida and Texas.

6 RN AND VN STATISTICAL UPDATE SEPTEMBER 1, 2013 TO AUGUST 31, 2014! Licensed Vocational Nurses! 99,347 with a current license! 87,132 with only a VN license 69,751 voluntarily report they are practicing full time 10,017 voluntarily report they are working part time 8,175 voluntarily report they are not working 3,313 voluntarily report they are working in another field! Registered Nurses! 272,128 with a current license 191,259 voluntarily report they are practicing full time 27,727 voluntarily report they are working part time 19,113 voluntarily report they are not working 7,412 voluntarily report they are working in another field

7 APRN UPDATE SEPTEMBER 1, 2013 TO AUGUST 31, 2014! Advance Practice Registered Nurses! 18,805 with a current Texas license! 704 with APRN licenses based on a compact license! 1,387 - Clinical Nurse Specialist! 4,324 - Nurse Anesthetist! Nurse Midwife! 13,360 - Nurse Practitioner * 14,285 have prescriptive authority

8 NURSING SCHOOLS/STUDENTS SEPTEMBER 1, 2013 TO AUGUST 31, 2014! # of RN Nursing Programs Approved - 118! # of VN Nursing Programs Approved - 95! # of RN Programs Sanctioned - 5! # of VN Programs Sanctioned 6! # of RN students taking the NCLEX 1 st Time 12,258! # of VN students taking the NCLEX 1 st Time 4,951! # of RN students completing a criminal background check 18,719! Hit Rate: 8.5%! # of VN students completing a criminal background check 9,196! Hit Rate: 14.9%

9 ENFORCEMENT SEPTEMBER 1, 2013 TO AUGUST 31, 2014! Total RN Complaints Opened 9,217! Total VN Complaints Opened 5,242! RN Complaints Resolved with Discipline 2,193! VN Complaints Resolved with Discipline 1,325! # of APRNs currently being monitored (discipline) 20! # of RNs currently being monitored (discipline) 2,197! # of VNs currently being monitored (discipline) 2,007! Average Number of Days to Complete an RN Investigation 91! Average Number of Days to Complete an VN Investigation - 103

10 CONTINUED COMPETENCY! Current BON requirements! 20 hours! Area of Practice! New Requirements Geriatrics and Jurisprudence! Current Competency Literature! Those most likely to be deemed competent are those who are:! Connected/networked professionally - Engaged! Express satisfaction with their career/career choice! Express satisfaction with their personal lives! Peer-referencing amongst the most powerful motivators and reinforcers for learning Charles Zubin, PhD The University of Toronto, Canada

11 CONTINUING EDUCATION CALCULATOR

12 NPA Amendments (SB 1058)! Substantive Amendments! Mandatory Criminal Background Checks for Students! Provide for limited nondisclosure of disciplinary proceedings! Make deferred discipline a permanent discipline option

13 SB 406: APRN Prescriptive Authority Proposal with amendments to the October Board Meeting Changes include: New definitions Clarify DEA only required on prescriptions for controlled substances Identifies the requirements for Prescriptive Authority Agreement Schedule II prescribing authority in certain settings Clarify ordering/prescribing behaviors that may result in discipline Continuing to work on Rule 221 and system for issuing licenses

14 Additional Bills! Increasing Capacity of Nursing Education Programs (HB 2099)! Common application for state nursing education programs if determined feasible by TX Higher Education Coordinating Board! Faculty loan repayment program with unused funds from the physician loan repayment program! Junior College Baccalaureate Degree Programs (SB 414)! Directs TX Higher Education Coordinating Board to conduct feasibility study to determine regions of TX that would benefit from public junior colleges offering a baccalaureate degree in nursing and applied sciences

15 NCSBN RESEARCH! Transition to Practice! The NCSBN and boards of nursing have been looking into the training and retention of new graduate nurses. Approximately 25% of new nurses leave a position within their first year of practice. Results are expected within the next year.! Simulation Study! Up to 50% simulation can be effectively substituted for traditional clinical experience in all pre-licensure core nursing courses under comparable conditions. The conditions include faculty members who were formally trained in simulation pedagogy, an adequate number of faculty members to support the student learners, subject matter experts who conduct theory-based debriefing, and equipment and supplies to create a realistic environment.

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17 Contact Information: Mark Majek Director, Operations Texas Board of Nursing 333 Guadalupe, Suite Austin, Texas