Oklahoma Nursing Educational Mobility Articulation Model

Transcription

1 Oklahoma Nursing Educational Mobility Articulation Model 2014 Nursing Programs Articulation Model Developed May 2014 by Oklahoma Action Coalition, Education Subcommittee

2 Table of Content Introduction... 3 Background... 3 Summary of 2000 ADN/BSN and LPN/ADN Articulation Agreements... 4 Purpose of Oklahoma Nursing Educational Mobility Articulation Model... 4 Policy Issues... 4 Assumptions... 5 Value of Nursing... 5 Barriers... 5 Transition... 5 Request and Action Needed... 6 Oklahoma Statewide Educational Mobility Nursing Articulation Model... 6 Nursing Common Core General Education Curriculum... 7 Oklahoma Nursing Program Information Appendix Nursing Competencies by Educational Level: Guidelines for Nursing Practice and Education in Oklahoma Nursing Competencies by Educational Level Degree and Average Age of RNs and LPNs in Oklahoma FY Percentage of Nurse/Degree Oklahoma Action Coalition for Educational Mobility Nursing Articulation Model Transition Courses (Developed from the Helene Fuld Grant 2005) Glossary of Terms History of Oklahoma Nursing Articulation References

3 Introduction In 2008, the Robert Wood Johnson Foundation (RWJF) and the Institute of Medicine (IOM) launched a two-year initiative to respond to the need to assess and transform the nursing profession. The IOM appointed the Committee on the RWJF Initiative on the Future of Nursing, at the IOM with the purpose of producing a report that would make recommendations for an actionoriented blueprint for the future of nursing. Through its deliberations, the Future of Nursing: Leading Change, Advancing Health report was published which includes four key messages: Nurses should practice to the full extent of their education and training. Nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression. Nurses should be full partners, with physicians and other health care professionals, in redesigning health care in the United States. Effective workforce planning and policy making require better data collection and information infrastructure. In an effort to meet the recommendations based on the key messages, Oklahoma has developed the Oklahoma Action Coalition. The Education subcommittee of this Coalition consists of nurse educators, members of the nursing industry, board of nursing representatives and others interested in helping nursing students move through a seamless educational system. The vision of students being able to obtain advanced degrees in nursing without repeating learned competencies and content is at the core of this proposal. The committee members are working on two of the recommendations from the IOM report: Recommendation 4: Increase the proportion of nurses with a BSN to 80% by o RN - BSN Increases o LPN - ADN/BSN Increases Recommendation 5: Double the number of nurses with a doctorate by The Education subcommittee, with the approval of the Deans and Directors of the practical nursing, associated degree and bachelor degree and higher nursing program, is recommending changes to the current articulation agreements and requesting adoption of the Oklahoma Nursing Educational Mobility Articulation Model. Background At the August 16, 1991 meeting, the State Regents endorsed the first nursing program articulation agreements. In 2000, the State Regents approved the revised articulation agreements model (below). Over the past 21 years, nursing programs in Oklahoma have continued to use an articulation policy that was initiated in 1991 and revised in Now, in response to the new recommendations by the IOM, the Education subcommittee of the Oklahoma Action Coalition has reviewed numerous state articulation agreements and proposes changes to the current articulation agreements based on that research and with feedback from the LPN, ADN, and BSN Deans and Directors organizations. 3

4 Summary of 2000 ADN/BSN and LPN/ADN Articulation Agreements 2000 ADN-RN Summary 2000 LPN-ADN Summary The proposed requirements allow institutions to award up to half of the total nursing hours, which represents an increase from 15 to a maximum of 22 credit hours, toward the Associate in Applied Science in Nursing for vocational-technical LPN courses if the following conditions are met: 1. All baccalaureate nursing programs will accept the same courses as prerequisites for admission. 2. ADN students will receive credit for approximately one-half of the nursing requirements for the BSN program under the following conditions: a) student is a graduate of an ADN program accredited by a United States Department of Education recognized accrediting agency; b) student passed the NCLEX examination for registered nurses; c) student completed satisfactorily all prerequisites to the nursing program. 3. Baccalaureate institutions should identify the major providers of ADN students and work cooperatively with faculty to facilitate articulation. student holds a valid LPN license in good standing and practices as an LPN; student must be a graduate of a program which is accredited by the NLNAC; the number of credit hours (up to half of the total nursing hours) will be determined by the individual institution; student must meet individual program admission requirements; and student demonstrates knowledge via (a) nursing practice experience or (b) a refresher course or equivalent. Purpose of Oklahoma Nursing Educational Mobility Articulation Model The health care needs of the multicultural population of Oklahoma demand an increase in the supply of nurses. One method of addressing this need is to increase opportunities for educational mobility for nurses in the workforce. A statewide educational articulation model provides an opportunity for a seamless career ladder in nursing. This model allows nursing students in nursing education programs to avoid unnecessary gaps or duplication of prior learning. In addition, the Oklahoma Nursing Educational Mobility Articulation Model facilitates educational mobility for licensed practical nurses by eliminating unnecessary barriers. The model has been developed though a collaborative effort of the Oklahoma Action Coalition Education Workgroup consisting of Practical, Associate, and Baccalaureate nurse educators, the Oklahoma Nurses Association, the Oklahoma Board of Nursing, nursing industry representatives, and others interested in nurse education mobility. Policy Issues The State Regents Standards of Education Relating to Credit for Extrainstitutional Learning (II-2-76) allows students to receive credit for academic learning that has occurred outside the formal college classroom setting via demonstration of learning by standardized tests approved for such 4

5 purposes, institutional examinations meeting specified criteria, learning recognized by the American Council on Education, and military occupational specialties. This policy is suited for LPN graduates to receive credit at formal college settings. These voluntary articulation agreements between Oklahoma s state system of nursing programs allow transfer students to forgo nursing courses that duplicate completed courses. This action constituted an exception to policy in that students knowledge would not be validated on a course-by-course basis. Assumptions The current agreements are consistent with the State Regents actions regarding nursing articulation. However, there is still the need to revise these agreements to continue to offer a seamless education experience for students that removes current barriers. The following assumptions are part of this model: Value of Nursing Nurses are vital to the wellness of Oklahomans. Educational advancement of nurses is essential to meet the needs of the evolving healthcare system. There is an inherent value and worth in each of the differing roles and competencies of all nurses and each is valued for its uniqueness. There is a common core of knowledge, attitudes, cognitive and psychomotor skills that graduates of all nursing programs must acquire. Articulation is a process through which nursing programs cooperate to facilitate educational progression of students with minimal repetition. Every nursing program in the state of Oklahoma must have an executable articulation agreement but may find it cumbersome or unfamiliar. Educational organizations operate as autonomous institutions and have the prerogative of establishing unique mission statements, goals, and standards for admission, progression, and graduation. Barriers Students and nursing programs continue to struggle with understanding and utilizing the current articulation agreements. Current methods of moving students through the nursing education system still have barriers for both the students and the nursing programs. Student barriers to advancing their nursing education include educational requirements, personal responsibilities, financial restraints, and geographic barriers. Nursing shortage in Oklahoma Nursing faculty shortage Transition In order to meet the demand for nurses, different methods must occur. Advancing to a higher nursing degree requires socialization. Each student needs to be aware of the different nurse roles and functions. In order to increase enrollment in nursing programs, all nurses need to be made aware of 5

6 articulation possibilities. State Regents approval is not required to have articulation agreements, because this model is consistent with the State Regents Transfer Policy. Investigation and development of other methods of transition of nurses into other degrees need to continue. Request and Action Needed The Oklahoma Council of Deans and Directors of Baccalaureate and Higher Degree Nursing Programs, the Oklahoma Associate Degree Nursing Directors Council, the Oklahoma Practical Nursing Director Council Oklahoma Articulation Model, and the Oklahoma Action Coalition requests support for the recent revisions and approval the Oklahoma Nursing Educational Mobility Articulation Model Oklahoma Statewide Educational Mobility Nursing Articulation Model Nursing Articulation Model: Student Articulation Criteria: Hold an unencumbered license in Oklahoma as an LPN or RN; Graduate of an United States Department of Education recognized accrediting agency; Meet individual nursing program admission requirements; Demonstrate knowledge via nursing practice experience or other methods as determined by the nursing program; Complete the Oklahoma Action Coalition for Educational Mobility Nursing Articulation Model Transition Course. (p.24) Non-Nursing (General Education) Credits: Awarding of LPN Nursing Credits toward ADN Prior ADN Nursing Credits Toward BSN All colleges and universities will accept the Common General Education Curriculum credits by using the Course Equivalency Project LPNs will receive a minimum of 15 nursing credit hours or up to half of the total nursing credit hours determined by the individual institution. RNs with an associate degree will receive credit for approximately half of the university nursing program required nursing credit hours as determined by the individual institution. Universities cannot place requirements on students transferring which are not required of their non-articulating students. RNs with an associate degree wishing to articulate directly to a master s program should contact the program for an individualized articulation plan. RNs with a Bachelor of Science in Nursing Degree wishing to articulate directly to a Doctorate in Nursing Practice (DNP) or the Doctor of Philosophy in Nursing (PhD) should contact the program for an individualized articulation plan. 6

7 Nursing Common Core General Education Curriculum Proposed statewide curriculum for Associate in Science Pre-BSN (for RNs to articulate to BSN level) IONE/IONE Workgroup Committee Members: Joyce Van Nostrand (NSU) and Debbie Morgan (NEO) with input from Charlotte Vaughn (Connors State) and Bethene Fahnestock (NEO). (2013) Per the Oklahoma Regents for Higher Education Policy (pp under Policy/Procedure, Chapter 3, Academic Affairs): Section A: Students recommended for the AA or AS degrees must achieve a GPA of 2.0 as a minimum on all course work attempted (a minimum of 60 hours) excluding any courses repeated or reprieved as detailed in the State Regents' Grading Policy and excluding physical education activity courses. The completion, as a portion of the overall 60 semester-credit hours, of a basic general education core, or a minimum of 37 semester-credit-hours, which shall include the following is required. (Note: this 37 credit hour basic general education core is also required for the baccalaureate degree): 1. English Composition 6 credit hours 2. U.S. History and U.S. Government 6 credit hours (see section ) 3. Science 6 credit hours (one course must be a laboratory science) 4. Humanities 6 credit hours (Chosen from nonperformance courses defined as humanities by the institution granting the associate degree) 5. Mathematics 3 credit hours 6. At least one course from the following areas: Psychology, social sciences, foreign languages, fine arts (art, music, drama) 3 credit hours 7. Additional liberal arts and sciences courses as needed to meet the minimum of 37 credit hours required in this policy. (State Regents' policies require a minimum of 40 credit semester hours of general education for the baccalaureate degree.) A discussion of the framework for the development of the general education curriculum appears later in this policy. Courses required for the general education program are not necessarily synonymous or mutually exclusive with the liberal arts and sciences. It is imperative that all institutions provide a means for credit by examination for established general education courses when individuals have attained a college-level grasp of selected subject matter. Credits earned consistent with the State Regents' Credit for Extrainstitutional Learning Policy may be used to satisfy general education requirements. Section B: The remaining minimum of 23 semester-credit-hours of academic work shall be applicable to the student's major objective including any prerequisite courses necessary for the anticipated upper-division program. A majority of such student credit hours should be taken in courses classified as liberal arts and sciences. Section C: The associate degree general education core of 37 semester credit-hours listed above shall be considered minimum and each institution may, with the approval of the State Regents, develop additional lower-division general education requirements for its own students. Section D: Students must demonstrate computer proficiency, which includes the competent use of a variety of software and networking applications. This requirement may be completed through one of three options: 1) successfully complete a high school computer science course that meets the State Regents' high school curricular requirements, or 2) satisfy an institution's computer proficiency 7

8 assessment, or 3) successfully complete college-level course work that the institution designates. Section E: The faculty of the awarding institution should have an opportunity to make a judgment as to the candidate's fitness for the degree. Therefore, a minimum of 15 hours of residence credit applied toward the associate degree shall be taken from the awarding institution, exclusive of correspondence work. Section F: Summary of minimum standards for AA and AS degrees: Number of Hours Required Total semester credit hours required 60 General education 37 Credit in residence at the awarding institution 15 (of the last 30). The Higher Learning Commission (HLC) requires 15 of the last 30 hours for an AA or AS. Course work applicable to major 23 Section A-37 hours Oklahoma State Regents for Higher Education General Education Requirements Credit Hours Section A 38 hours Nursing Common Core General Education Credit Hours 1) English Composition 6 English Composition I 3 English Composition II 3 2) US History and US Government 6 American Government 3 American History 3 3) Science (one course must be a laboratory science) 4) Humanities (chosen from nonperformance courses defined as humanities by the institution granting the associate degree). 6 *Chemistry (lab science) 4 Microbiology (lab science) 4 6 Humanities 6 5) Mathematics 3 **College Algebra 3 6) At least one course from the following areas: psychology, social sciences, foreign languages, fine arts (art, music, drama) 3 Psychology 3 7) Additional liberal arts and science courses as needed to meet the minimum total of 37 credits in this policy. State Regents policies require a minimum of 40 semester hours of general education for the baccalaureate degree). 7 Nutrition Developmental Psychology Section A Total Section B 23 hours Oklahoma Regents for Higher Section B 22 hours Support Courses for Major Education 3 3 Course Work Applicable to Major (in this case Nursing) 23 ***Anatomy (4 hours) + Physiology (4 hours) OR 8 8

9 ***A&P I (4 hours) + 8 A&P II 4 hours) OR ***A&P combined (4 hours) + 8 Advanced Physiology (4 hours) OR ****Combined A&P 5 Elementary Statistics 3 Computer Literacy Course 3 Sociology (?) 3 Orientation course (?) 1 *****Electives to fulfill 60 hours 4 Section B Total Overall Total *Propose developing a statewide 4-hour course Chemistry for Health Science majors (with lab) that blends both organic and inorganic introductory concepts (such as osmosis, acid-base balance, etc.) to better prepare students to assimilate this knowledge with nursing concepts or modification of current chemistry course. Students would need to demonstrate math proficiency for admission into this course with: 1) Math ACT of 19 or greater, or 2) standardized CPT or COMPASS scores that show readiness for College Algebra, or 3) successful completion of Intermediate Algebra. A consensus would need to be achieved to determine what math proficiency means to all colleges. Students would also need to demonstrate reading proficiency for admission into this course with: 1) Reading ACT 19 or greater, or 2) standardized CPT or COMPASS scores that show reading deficiency is cleared, or 3) successful completion of a developmental reading course. This Chemistry for Health Science majors class would require no pre-requisites other than demonstration of math and reading competency. The goal would also be for this class to meet the chemistry requirement as students progress to the BSN level and not require a secondary chemistry course. In previous discussions, it has been noted that many universities would not accept a course of this type for their chemistry requirement again, could this concept be revisited and an agreed upon curriculum be developed? **As part of the Complete College America initiative through the Oklahoma Regent for Higher Education, a statewide Math Task Force has been formed and is slated to begin work March 2013 to evaluate high school and college math curriculum, and evaluate math readiness, remediation, and reforms needed to better prepare Oklahoma students in this critical area. Perhaps College Algebra is not what is needed for nursing maybe statistics could better fill the math requirement for the Pre-BSN degree and not require College Algebra as a pre-requisite. More discussion and research of best practices from other states is needed in this area as this task force moves forward; our committee needs to keep apprised of its progress and provide input as needed as it relates to nursing. ***The question of how much anatomy and physiology preparation is needed for nursing at the ADN and BSN level (and if 8 hours of A&P is the agreed upon number), and how it is packaged is an area for discussion. These courses are often difficult to transfer dependent upon what was taken at the associate level and what the transferring university requires in this area. Can we decide on one A&P option statewide? Does having the three (3) options give flexibility for schools (and courses that are already created and in use), or does it create barriers for students to progression at the BSN level? 9

10 These are questions to discuss. ****Some programs offer a combined A&P 5-hour course versus separating into separate anatomy and physiology courses. Again, discussion would need to focus on what amount of A&P is needed for preparation for entry into RN-BSN programs (5 hours versus 8 hours). *****Elective numbers can change based on what is required at each college. For example not all may require an orientation class as part of the degree audit. Again, the overall goal would be for the proposed statewide Chemistry for Health Science majors course to work as the pre-requisite course for both Anatomy & Physiology (whether 4 or 8 hours) and Microbiology (4 hours). We would need to get science faculty involved in these discussions (and they may not agree), but we are talking about removing barriers for nurses to advance their education, so options will need to be explored. We cannot do what we have always done and expect a different outcome. Additionally: *30 hours for AAS Nursing Degree *30 hours for RN-BSN ( = major/minor) 124 hours total 10

11 Oklahoma Nursing Program Information Degree options available evolve quickly. Please access current information about Oklahoma nursing programs from the following lists on the Oklahoma State Board of Nursing website. 11

12 Appendix (subject to change) OKLAHOMA BOARD OF NURSING 2915 North Classen Blvd., Suite 524 Oklahoma City, OK (405) Nursing Competencies by Educational Level: Guidelines for Nursing Practice and Education in Oklahoma I. Purpose: This model identifies competencies for the roles of nurses with various levels of nursing education: practical (P.N.), associate (A.D.N.), baccalaureate (B.S.N.), master s (M.S.), and doctoral. II. Introduction: In 2001, a Nurse Utilization Task Force appointed by the Oklahoma Board of Nursing developed this model to address questions received by the Board members and staff regarding the appropriate utilization of nurses at each level of education. In , the model was reviewed and updated by a Subcommittee of the Nursing Education and Practice Advisory Committee. In 2013, Nursing Education and Nursing Practice Advisory Committee reviewed and approved the updated document. In the model, competencies that are common to all categories are identified at the level of education in which they are taught, and are not repeated at the successive levels. Since there are no diploma schools of nursing in Oklahoma, this model does not include a diploma category. The Oklahoma Board of Nursing provides this model as a mechanism to assist nurses in education and practice with decisions regarding nursing curricula, articulation between educational levels, and nursing roles in various practice settings. The model does not mandate nursing roles, curriculum, or articulation, but rather, it is available as a resource for Oklahoma nurses. When the original model was revised in , new competencies were used as the framework, as developed in 2003 by the Institute on Medicine (IOM). The IOM identified a set of five core competencies to be demonstrated by all health care professionals to meet the needs of the 21st-century health system (Greiner & Knebel, 2003). The five core competencies are: Provide patient-centered care; Work in interdisciplinary teams; Employ evidence-based practice; Apply quality improvement; and Utilize informatics. These competencies are defined in Section III below. 12

13 In the revisions completed in 2013, the Essentials of Baccalaureate Education for Professional Nursing Practice (2009), The Essentials of Master s Education for Advanced Practice Nursing (2011), and The Essentials of Doctoral Education for Advanced Nursing Practice (2006), published by the American Association of Colleges of Nursing, were used as key references for revising sections related to baccalaureate and master s level education, as well as for adding a new section on doctoral education. However, because master s and doctoral nursing education prepares nurses for other roles besides advanced practice, sections that focused on general competencies for all master sor doctoral-prepared nurses were used. Other key references used in the 2013 revisions are identified in Section #V. III. Definitions Applying Quality Improvement: Identifying errors and hazards in care; understanding and implementing basic safety design principles, such as standardization and simplification; continually understanding and measuring quality of care in terms of structure, process, and outcomes in relation to patient and community needs; designing and testing interventions to change processes and systems of care, with the objective of improving quality. Clients: The term clients is used in this document to describe the recipients of nursing care. Clients for licensed practical and associate degree nurses include individuals, families and groups. Clients for baccalaureate nurses include individuals, families, groups, and communities. Clients for nurses prepared at the master s level include individuals, families, groups, communities, and populations. Competence: The application of knowledge and the interpersonal, decision-making and psychomotor skills expected for the practice role, within the context of public health, safety, and welfare (NCSBN, retrieved on 1/15/2010 from Employing Evidence-Based Practice: Integrating best research with clinical expertise and patient values for optimum care, and participating in learning and research activities to the extent feasible. Essentials of Baccalaureate Nursing Education, as defined by AACN (2009): 1. Liberal education for baccalaureate generalist nursing practice 2. Basic organizational and systems leadership for quality care and patient safety 3. Scholarship for evidence-based practice 4. Information management and application of patient care technology 5. Health care policy, finance, and regulatory environments 6. Interprofessional communication and collaboration for improving patient health outcomes 7. Clinical prevention and population health 8. Professionalism and professional values 13

14 9. Baccalaureate generalist nursing practice Essentials of Master s Education in Nursing, as defined by AACN (2011): 1. Background for Practice from Sciences and Humanities 2. Organizational and Systems Leadership 3. Quality Improvement and Safety 4. Translating and Integrating Scholarship into Practice 5. Informatics and Healthcare Technologies 6. Health Policy and Advocacy 7. Interprofessional Collaboration for Improving Patient and Population Health Outcomes 8. Clinical Prevention and Population Health for Improving Health 9. Master s Level Nursing Practice Essentials of Doctoral Education for Advanced Nursing Practice (AACN, 2006): 1. Scientific underpinnings for practice 2. Organizational and systems leadership for quality improvement and systems thinking 3. Clinical scholarship and analytical methods for evidence-based practice 4. Information systems/technology and patient care technology for the improvement and transformation of health care 5. Health care policy for advocacy in health care 6. Inter-professional collaboration for improving patient and population health outcomes 7. Clinical prevention and population health for improving the nation s health 8. Advanced Nursing Practice Nursing: The practice of nursing means the performance of services provided for purposes of nursing diagnosis and treatment of human responses to actual or potential health problems consistent with educational preparation. Knowledge and skill are the basis for assessment, analysis, planning, intervention, and evaluation used in the promotion and maintenance of health and nursing management of illness, injury, infirmity, restoration or optimal function, or death with dignity. Practice is based on understanding the human condition across the human lifespan and understanding the relationship of the individual within the environment. This practice includes execution of the medical regime including the administration of medications and treatments prescribed by any person authorized by state law to so prescribe. [Title 59 O.S a.2]. Providing Patient-Centered Care: Identifying, respecting and caring about patients differences, values, preferences, and expressed needs; relieving pain and suffering; coordinating continuous care; listening to, clearly informing, communicating with, and educating patients; sharing decision making and management; and continuously advocating disease prevention, wellness, and promotion of healthy lifestyles, including a focus on population health. Utilizing Informatics: Communicating, managing knowledge, mitigating error, and supporting decision making using information technology. 14

15 Working in Interdisciplinary Teams: Cooperating, collaborating, communicating, and integrating care in teams to ensure that care is continuous and reliable. IV. Regulatory Authority: 59 O.S a.1 V. References American Association of Colleges of Nursing. (2009) The Essentials of Baccalaureate Education for Professional Nursing Practice. Retrieved January 11, 2013, from American Association of Colleges of Nursing. (2006) The Essentials of Doctoral Education for Advanced Nursing Practice. Retrieved January 25, 2010, from American Association of Colleges of Nursing. (2011) The Essentials of Master s Education for Advanced Practice Nursing. Retrieved January 11, 2013, from Greiner, A. & Knebel, E. (Eds.) (2003) Health Professions Education: A Bridge to Quality. Institute of Medicine of the National Academy of Sciences: Washington, D.C. National Federation of Licensed Practical Nurses. (2003). NFLPN Nursing Practice Standards for the Licensed Practical/Vocational Nurses. National Association for Practical Nurse Education and Service. (2007). NAPNES Standards of Practice and Educational Competencies of Graduates of Practical/Vocational Nursing Programs. Oklahoma Nursing Practice Act, Title 59, Oklahoma Statute Chapter 12, et seq. (2003). Quality and Safety Education for Nurses National Advisory Board. (n.d.). Quality and Safety Education for Nurses: Pre-Licensure and Graduate Knowledge, Skills, and Attitudes. Retrieved January 25, 2010, from The Joint Commission. (2010) National Patient Safety Goals. Retrieved January 25, 2010, from 15

16 Nursing Competencies by Educational Level COMPETENCY #1: PROVIDING CLIENT-CENTERED CARE ROLES PN ADN BSN MASTERS DOCTORATE Caregiver Assists in the implementation of established plans of care for clients. Provides clientcentered care with sensitivity, empathy Uses concepts from nursing and other disciplines to plan, coordinate, implement, and evaluate nursing care designed to promote, restore, Uses scientific and nursing knowledge (including current evidence from nursing research) to plan, coordinate, implement, and evaluate nursing Uses specialized knowledge and expertise to influence, design, coordinate, implement, and evaluate comprehensive, Advances situational exposure and evidence based practice to prepare, plan, or implement client care. Uses advanced knowledge and respect for the and/or maintain optimal care for clients in a integrated care to to develop care diversity of human experience. outcomes. variety of settings. increasingly complex, diverse populations in multiple environments across the lifespan. delivery models, health policies, and practice guidelines. Advocate Protects the health, safety and rights of the client. Uses knowledge of consumers rights/responsibilities and health policy to plan care and intervene on behalf of clients. Actively engages in policy processes defining healthcare delivery and systems of care in order to support the client s participation in healthcare decisions. Uses knowledge and skills to promote health and shape the healthcare delivery system through healthcare policy development. Designs, develops, and educates others regarding healthcare policies. Organizes policies so that they are easily accessible and useful. Teacher Provides basic health teaching for clients, using established teaching plans. Develops, implements, and evaluates teaching plans for clients using evidence-based practice. Uses theoretical knowledge and communication skills to develop, coordinate, implement and evaluate clientcentered teaching plans. Uses advanced theoretical knowledge, teaching principles, and teaching strategies to design, coordinate, implement, and evaluate comprehensive teaching programs for multiple environments. Plans, designs, implements, evaluates, and organizes teaching programs for clients.

17 COMPETENCY #1: PROVIDING CLIENT-CENTERED CARE ROLES PN ADN BSN MASTERS DOCTORATE Communicator/ Counselor Communicates with clients incorporating interpersonal and therapeutic communication skills; observing client confidentiality and professional boundaries. Establishes and maintains therapeutic relationships. Effectively listens to, communicates with, and educates clients and other caregivers about health, wellness, and disease management and prevention. Develops, coordinates, and evaluates therapeutic relationships and counseling strategies. Organizes bodies of knowledge for planning, designing, implementing, and evaluating therapeutic relationships and counseling strategies. Decision Maker Uses problem-solving skills to make decisions and prioritize basic health care needs. Uses critical thinking and research-based informatics as a basis for responding to changes in health care needs. Uses current evidence from nursing and healthcare research to evaluate healthcare needs and improve the healthcare environment. Uses acquired knowledge and skills to challenge assumptions and effect change in practice and profession. Uses clinical scholarship and analytical methods for evidence based practice and clinical prevention. Analyzes population health to validate decisions and trends regarding the nation s health. 17

18 COMPETENCY #2: WORK IN INTERDISCIPLINARY TEAMS ROLES PN ADN BSN MASTERS DOCTORATE Collaborator Shares an interdependent relationship with other health care team members for the purpose of improving client outcomes. Participates in collegial relationships for the purpose of establishing continuity of care. Establishes, promotes and evaluates the care environment for the purpose of improving client outcomes while promoting civility and an environment of safety for diverse individuals. Establishes and evaluates professional networks for the purpose of improving client outcomes while utilizing theory to address complex issues and design care to meet the needs of multiple populations. Uses interprofessional collaboration, for the purpose of improving client and population health outcomes. Manager Supervises care provided by unlicensed assistants. Collaborates in coordination of human, informatics, and material resources in structured settings. Manages small groups of caregivers in structured settings. Assumes a positive role in planning, coordinating, organizing, and evaluating the effective use of human, fiscal, and physical resources within the healthcare environment. Delegates and directs nursing team resources (human and fiscal) in collaboration with the team. Uses organizational and leadership skills in quality improvement and systems thinking, for the purpose of improving client and population health outcomes through management of care. Facilitator Participates in group process to promote the provision of nursing care. Uses knowledge of group dynamics to improve client outcomes. Uses group concepts to develop an environment focused on quality improvement, safety and accountability. Advances group efforts to improve care through integration of scientific findings from multiple disciplines to provide quality care to multiple populations. Uses organizational and leadership skills in individual and group facilitation, for the purpose of improving client and population health outcomes. 18

19 COMPETENCY #2: WORK IN INTERDISCIPLINARY TEAMS ROLES PN ADN BSN MASTERS DOCTORATE Ethicist Complies with the ethical, legal, and Anticipates and contributes to the Uses the ethical decision-making Uses ethical analysis and clinical reasoning Functions as a key member of IRB regulatory frameworks ethical decision- process to examine to influence health care committees for the of nursing and the scope of practice that making process. Participates within potential ethical situations and resolve practices. Uses additional knowledge purpose of ethical research is consistent with the legal boundaries as a ethical dilemmas. and clinical expertise to understanding. Oklahoma Nursing Practice Act. Incorporates moral concepts and respect for diverse values and beliefs. Identifies and communicates ethical dilemmas. contributing member to the profession and advancement of nursing. resolve ethical dilemmas. Uses health care policy for advocacy in health care. COMPETENCY #3: EMPLOY EVIDENCE-BASED PRACTICE ROLES PN ADN BSN MASTERS DOCTORATE Scholar Maintains competence and professional growth through lifelong learning. Incorporates professional development to improve health care and advance the profession. Uses research findings and other evidence to provide multidimensional, high quality, and costeffective care in a changing environment. Commits to evidencebased practice to improve health care and advance the profession while promoting life long learning and critical thinking in all. Disseminates findings and information electronically, and by publication and oral presentation when applicable. 19

20 Researcher Participates in collecting client outcomes data. Participates in research team activities and uses interpreted nursing research findings to improve client care and client safety.. Evaluates research reports, using current standards, to determine appropriateness for utilization in clinical practice. Functions as a team member in facilitating research projects. Shares evidence of best practices with interprofessional team. Contributes clinical expertise to create a climate in the practice setting that supports scholarly inquiry, evidence-based practice, and scientific investigation. Provides leadership for designing research and integrating findings in health care practice. Develops, transmits, applies, and organizes research methodologies as applicable for specific clinical settings. COMPETENCY #4: APPLY QUALITY IMPROVEMENT ROLES PN ADN BSN MASTERS DOCTORATE Safety Outcomes Participates as a team member in implementing standardized practices Uses National Patient Safety Goals (NPSGs) for client care, staff scheduling, and Evaluates the healthcare environment, systems of care and client and Articulates methodology, tools, performance measures and standards as they Organizes bodies of knowledge to design safe practice guidelines. that support safety and quality, and reduce risk of harm to self and others. Reports errors and supports members of the health care team to be forthcoming about errors and near misses. regulation of work flow. community needs within the context of NPSGs. Supports organizational change to improve quality. relate to safety. 20

21 Quality Care Implements principles of quality in carrying out basic care. Participates in and utilizes research from quality improvement studies to improve client care. Evaluates and participates in research to improve the quality of care in terms of structure, process and outcomes. Assumes a leadership role in effectively implementing patient safety and quality improvement initiatives within the context of the inter professional team using effective communication skills. Uses and organizes information systems/technolog y and client care technology for the improvement and transformation of health care. COMPETENCY #5: UTILIZE INFORMATICS ROLES PN ADN BSN MASTERS DOCTORATE User of Information Technology Board Approved: 2001 Board Reviewed w/o Revision: Board Revised: 5/25/10; 7/30/13 Utilizes information technology to provide care, reduce medical errors and support health care interventions. Uses information technology for the improvement of client care and client safety. Understands, practices and teaches all aspects of client confidentiality pertaining to informatics. Evaluates the use of information technology to ethically manage data, effectively communicate, improve client care and safety, and inform practice decisions. Integrates client care technologies into plans of care and determines the appropriate use of technologies to deliver or enhance care. Disseminates knowledge to the healthcare team in order to promote quality outcomes. OBN Policy/Guideline: #P-21 Page 6 of 3 Develops and organizes IT programs that assist in tracking and trending research and best practice outcomes and findings. Assists others in tracking relevant clinical outcomes. P:/Administration/Executive/Policies/Practice/EdLevelCompet encies 21

22 Degree and Average Age of RNs and LPNs in Oklahoma FY2013 Board of Nursing, Annual Report and Statistical Data for the Fiscal Year Ended June 30, 2013 Percentage of Nurse/Degree Post-Master s Certificate Advanced Practice Certificate Doctorate Nursing Other Doctorate Nursing Practice Doctorate Non-Nursing Doctorate Nursing (PhD) Master s Non-nursing Master s Nursing Baccalaureate-Non-nursing Baccalaureate-Nursing Diploma in Nursing Associate Degree Diploma or Associate Degree 0.20% 0.60% 0.01% 0.06% 0.46% 0.16% 3.42% 6.34% 4.35% Percentage of RNs 3.89% 6.61% 32.04% 36.98% 0.00% 5.00% 10.00% 15.00% 20.00% 25.00% 30.00% 35.00% 40.00% 22

23 Board of Nursing, Annual Report and Statistical Data for the Fiscal Year Ended June 30, 2013 Board of Nursing, Annual Report and Statistical Data for the Fiscal Year Ended June 30,

24 Oklahoma Action Coalition for Educational Mobility Nursing Articulation Model Transition Courses (Developed from the Helene Fuld Grant 2005) LPN-RN Course Description: This course utilizes a framework developed by the Oklahoma Board of Nursing to provide a basis for educational mobility of licensed practical nurses. The content of the course is built from The Essential Competencies of Oklahoma Graduates of Licensed Practical Nurses, Associate Degree Registered Nursing Programs and Baccalaureate Degree Registered Nursing Programs developed by Oklahoma Nursing Articulation Consortium. The student will utilize previous nursing education to develop the knowledge and skills required for professional nursing practice. The LPN-RN Transition Course is designed to validate prior learning and update and enhance nursing knowledge. The course facilitates transition from the role of practical nurse to that of a student preparing for the role of associated level prepared registered nurse. The role of the registered nurse is based on the nursing competences by educational level as outlined by the Oklahoma Board of Nursing. The nursing process is used as the framework for critical thinking, clinical reasoning, and problem solving. Credit Awarded: The workload of the course is comparable to a 1-credit course. Upon successful completion of the course and admission to one of the participating ADN (RN) nursing programs, the student will be granted nursing credits based on the Oklahoma Action Coalition for Educational Mobility Nursing Articulation Model. LPN to RN Learner Outcomes: Upon completion of this course, the student will be expected to: 1. Complete an assessment of learning styles and develop personal goals for becoming licensed as a registered nurse. 2. Describe professional socialization process as it relates to personal educational mobility goals. 3. Identify various theories of nursing practice. 4. Describe the influence of historical events on the development of nursing as a profession. 5. Describe the history of nursing education programs. 6. Compare and contrast the scope of practice of licensed practical nurses, registered nurses, and advanced practice nurses. 7. Discuss the roles of the professional nurse. 24

25 8. List the characteristics of the critical thinking process, nursing process, problem-solving process, and decision-making process. 9. Identify legal issues related to nursing education and nursing practice. 10. Identify ethical issues related to nursing practice. 11. Discuss the relationship between political action and the profession of nursing. 12. Identify the mission and purpose of professional nursing organizations. COURSE CONTENT UNIT 1: INTRODUCTION TO COURSE 1. Introduction to Online Learning 2. Introduction to Conceptual Framework for Course 3. Assessment of Learning Styles 4. Returning to School 5. Time Management A. Role Conflicts and Stressors B. Educational Conflicts and Stressors UNIT 2: PROVIDER OF CARE 1. Caregiver A. Scope of Practice B. Critical Thinking 2. Advocate A. Regulation of Nursing Practice B. Professional Liability 3. Teacher A. Adult-Learning Theory B. Responsibility of Learner in Educational Process C. Assessment of Learning Styles 4. Communicator/Counselor A. Conflict Resolution B. Communication Skills for Professional Practice UNIT 3: MEMBER OF THE PROFESSION 1. Scholar Nursing History History of Nursing Education Political Action Professional Associations 2. Collaborator 25

26 A. Professional Socialization B. Collegial Relationships 3. Ethicist A. Nursing s Code of Ethics B. Ethical Principles C. Ethical Dilemmas in Nursing D. Ethical Decision Making 4. Researcher A. Knowledge Base for Nursing Practice B. Major Concepts in Nursing Theories C. Nursing Research as a Source of Knowledge Base UNIT 4: LEADER 1. Manager A. Promotion of Career Goals B. Collegial Relationships C. Personal Human Resources 2. Facilitator A. Group Process B. Peer Review 3. Decision-Maker A. Change Agent B. Changes in World View 4. User of Information Technology A. Nursing Informatics B. Use of Technology in Professional Development Teaching methods: A variety of online instructional modalities that support self-directed learning are used. Evaluation criteria and grading: The student must achieve a grade of satisfactory on all four required projects. Students have one opportunity to revise and resubmit an unsatisfactory project. Nursing Competencies by Educational Level COMPETENCY #1: PROVIDING CLIENT-CENTERED CARE ROLES ADN BSN 26

27 Caregiver Advocate Teacher Communicator/ Counselor Uses concepts from nursing and other disciplines to plan, coordinate, implement, and evaluate nursing care designed to promote, restore, and/or maintain optimal outcomes. Uses knowledge of consumers rights/responsibilities and health policy to plan care and intervene on behalf of clients. Develops, implements, and evaluates teaching plans for clients using evidence-based practice. Establishes and maintains therapeutic relationships. Decision Maker Uses critical thinking and researchbased informatics as a basis for responding to changes in health care needs. Uses scientific and nursing knowledge (including current evidence from nursing research) to plan, coordinate, implement, and evaluate nursing care for clients in a variety of settings. Actively engages in policy processes defining healthcare delivery and systems of care in order to support the client s participation in healthcare decisions. Uses theoretical knowledge and communication skills to develop, coordinate, implement, and evaluate client- centered teaching plans. Effectively listens to, communicates with, and educates clients and other caregivers about health, wellness, and disease management and prevention. Uses current evidence from nursing and healthcare research to evaluate healthcare needs and improve the healthcare environment. COMPETENCY #2: WORK IN INTERDISCIPLINARY TEAMS ROLES ADN BSN Collaborator Participates in collegial relationships for the purpose of establishing continuity of care. Establishes, promotes, and evaluates the care environment for the purpose of improving client outcomes while promoting civility and an environment of safety for diverse individuals. Manager Facilitator Collaborates in coordination of human, informatics, and material resources in structured settings. Manages small groups of caregivers in Uses structured knowledge settings. of group dynamics to improve client outcomes. Assumes a positive role in planning, coordinating, organizing, and evaluating the effective use of human, fiscal, and physical resources within the healthcare environment. Uses group concepts to develop an environment focused on quality improvement, safety, and accountability. 27

28 COMPETENCY #2: WORK IN INTERDISCIPLINARY TEAMS ROLES ADN BSN Ethicist Anticipates and contributes to the ethical decision- making process. Participates within legal boundaries as a contributing member to the profession and advancement of nursing. Uses the ethical decision-making process to examine potential ethical situations and resolve ethical dilemmas. COMPETENCY #3: EMPLOY EVIDENCE-BASED PRACTICE ROLES ADN BSN Scholar Incorporates professional development to Uses research findings and other improve health care and advance the profession. evidence to provide multi- dimensional, high quality, and cost- effective care in a changing environment. Researcher Participates in research team activities and uses interpreted nursing research findings to improve client care and client safety.. Evaluates research reports, using current standards, to determine appropriateness for utilization in clinical practice. Functions as a team member in facilitating research projects. Shares evidence of best practices with interprofessional team. COMPETENCY #4: APPLY QUALITY IMPROVEMENT ROLES ADN BSN Uses National Patient Safety Goals (NPSGs) for client care, staff scheduling, and regulation of workf l o w. Safety Outcomes Evaluates the healthcare environment, systems of care and client and community needs within the context of NPSGs. Quality Care Participates in and utilizes research from quality improvement studies to improve client care. Supports organizational change to improve quality. Evaluates and participates in research to improve the quality of care in terms of structure, process, and outcomes. COMPETENCY #5: UTILIZE INFORMATICS ROLES ADN BSN 28