Educational Transformation in Wyoming Master Plan: REvolutionizing Nursing Education in Wyoming (RENEW)

Transcription

1 Educational Transformation in Wyoming Master Plan: REvolutionizing Nursing Education in Wyoming (RENEW) Wyoming Center for Nursing and Health Care Partnerships Strengthening the nursing workforce through ongoing collaboration, communication, and consensus building to meet the health needs of the people of Wyoming. Prepared by Mary E. Burman Matt Sholty 2011 Project Funded by the Wyoming Workforce Development Council

2 Background A shortage of nurses to provide competent, safe nursing care to the U.S. population is expected to intensify in the approaching decades unless immediate remedial action is implemented. Nationally, it has become increasingly clear that one of the key issues to resolving the worsening nursing workforce shortage is to address educational capacity 1. Several barriers prevent increasing the nursing educational capacity. First, there is a growing and concerning faculty shortage which limits the number of students schools of nursing can accept into their programs. The average age of a nursing faculty member in the US is now ~54 years 2 and nursing faculty typically retire around age 62.5 years 3. According to a survey by the National League of Nursing and the Carnegie Foundation, half of current nursing faculty members are expected to retire in the next ten years 4. Second, insufficient number and inefficient use of clinical sites in hospitals, long-term care facilities and other health care organizations, compound the faculty shortage both nationally and for the state of Wyoming. Competition for some clinical sites is a problem, while other sites are underused because of a variety of factors, including size, preparation of nursing staff and location. The State of Wyoming faces similar challenges with an impending shortage of nurses and faculty. Wyoming is also predicted to experience a shortage of nurses. The Wyoming Department of Employment reported that in 2014, 3,307 more registered nurses (RNs) will be needed in Wyoming compared to 2006, which represents a 103.9% increase 5. In order to adequately address the nursing shortage in Wyoming, a systematic examination of nursing education capacity in the state is needed. It is apparent that all industry partners need to come together to explore creative ways to expand nursing education through curriculum and clinical 1 Aiken, L. H., Cheung, R. B., & Olds, D. M. (2009). Education policy initiatives to address the nurse shortage in the United States. Health Affairs, 28(4), W646-W Cleary, B. L., McBride, A. B., McClure, M. L., & Reinhard, S. C. (2009). Expanding the capacity of nursing education. Health Affairs, 29(4), W634-W645 3 National Advisory Council on Nurse Education and Practice. (2008). Meeting the Challenges of the New Millennium: Challenges Facing the Nurse Workforce in a Changing Health Care Environment. Available at: ftp://ftp.hrsa.gov/bhpr/nursing/sixth.pdf. 4 Scheckel, M. & Valiga, T. M. (2007). Introducing the NLN/Carnegie National Survey of Nurse Educators. Nursing Education Perspectives, 28(3), Wyoming Department of Employment (2008). Nurses in Demand: Statement of the Problem. Casper, WY: Author. Available at: 2

3 redesign, strategic partnerships, and enhanced faculty capacity. Nationally, a number of strategies are being proposed to enhance educational capacity, including accelerated programs for developing nurse educators, expanded use of low to high tech simulation, innovative partnerships to redesign clinical education, use of nurse clinicians in expanded preceptor and teaching roles, and centralized student placement systems 6,7. Project Overview In order to examine what strategies would be effective in Wyoming, the Wyoming Center for Nursing and Health Care Partnerships (WCNHCP) held two educational capacity summits, one in May 2010 and the other in May 2011, facilitated by consultants from the Oregon Consortium for Nursing Education (OCNE); undertook a survey of nurse educators, staff nurses, and clinical facilities to quantify educational capacity; funded three educational capacity projects; and a completed a review of the literature and research on nursing education (see wynursing.org for summaries of the surveys, pilot projects and literature review). Following the first nursing education summit in May 2010, the WCNHCP developed a steering committee to facilitate development of the plan to transform nursing education in Wyoming with representatives from the WCNHCP, UW, the community colleges, clinical practice, specifically acute care, long-term care, public health, and the Wyoming State Board of Nursing. Members of the steering committee used themes identified at the nursing education summits, the outcomes of the education capacity projects, and the results of the surveys and the systematic literature review to develop a statewide master plan to transform nursing education in the State of Wyoming. This initiative is referred to as RENEW (REvolutionizing Nursing Education in Wyoming). 6 Joynt, J. & Kimball, B. (2008). Blowing Open the Bottleneck: Designing New Approaches to Increase Nurse Education Capacity. Available at: 7 National League for Nursing (2008). NLN Think Tank on Transforming Clinical Nursing Education. Available at: 3

4 Statewide Plan The RENEW initiative seeks to enhance the quality of nursing and health care in Wyoming by building a stable, adequate nursing workforce. This goal will be achieved through implementation of a common, competency-based statewide curriculum where students can start at any Wyoming community college and earn an associate degree and continue seamlessly on to the University of Wyoming (UW) and earn a bachelor degree (or higher). The curricular redesign will ensure that nurses are knowledgeable, skilled and capable of addressing the needs of the community. The initiative is closely aligned with the recommendations from the Institute of Medicine (IOM) in their recently released publication on the Future of Nursing 8. The IOM recommends that nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression. They specifically recommend that the proportion of nurses with a baccalaureate degree be increased to 80 percent by The overall aim of RENEW is to enhance the quality of nursing and health care in Wyoming by revolutionizing nursing education. The vision of RENEW is to revolutionize nursing education by developing the following: Shared, competency-based statewide curriculum where students can earn an associate degree then continue on seamlessly to a BSN degree (or higher) starting at any of the community colleges and continuing to the University of Wyoming. The courses/clinical experiences needed to complete the BSN through the university will be available through distance delivery. Shared leadership through education and practice partnerships to: Co-create the nursing curriculum Optimize the use of clinical facilities and faculty throughout the state of Wyoming Share educational and clinical resources 8 Institute of Medicine (2011). The future of nursing. Leading change, advancing health. Washington, DC. The National Academies Press. 4

5 A clinical education model focusing on enhancing clinical judgment, skill development and professional nursing practice. RENEW requires a statewide collaborative process involving multiple individuals and organizations. To enhance that work, a set of Guiding Principles has been developed. Valuing both ADN and BSN education Focusing on quality nurses and quality nursing care to educate the best nurses possible Using a shared leadership model that encourages mutual and dynamic partnerships between nursing education and clinical facilities Using a consensus approach to decision-making which doesn t mean 100% agreement, but focuses on bringing all voices to the table and identifying the best strategy for moving forward Valuing relationships Valuing healthy conflict and agreeing to disagree Retaining individual program/clinical facility autonomy Valuing inclusivity and diversity Valuing a positive approach to change Thinking big having an attitude of thinking out of the box and committing to transformation of nursing in Wyoming. In order to facilitate the development and implementation of the statewide curriculum, an organizational structure has been develop for RENEW, that includes the overall RENEW initiative, the RENEW Steering Committee and specific committees. 5

6 RENEW Coordinated/facilitated by the Wyoming Center for Nursing and Health Care Partnerships Statewide Nursing Education Consortium composed of the following: o Full and associate member schools o Clinical partners and other key stakeholder RENEW Steering Committee Leadership: Chair from WCNHCP Membership: WCNHCP, community college and university, clinical partners, Wyoming State Board of Nursing, and other key stakeholder representatives Voting: A consensus model is being used in RENEW, but if a vote is needed each member of the steering committee has a vote. Charges/Objectives: o Oversight and coordination between committees o Communication/marketing/visibility o Membership development o Resource development o Facilitate evaluation of RENEW RENEW Committees 6

7 Curriculum Committee Professional Education Committee Clinical Education Committee Student Support Services Leadership: Co-chairs one representing UW or community college and one representing clinical partner. Membership: community college and university faculty with representatives from all participating member schools, representatives from clinical practice and other key stakeholders Voting: A consensus model is being used in RENEW, but if a vote is needed each member of the committee has a vote. Charges/Objectives: o Finalize curricular framework, e.g., outcomes, core curricular concepts and key professional attributes o Develop curriculum overview with prerequisite courses and nursing courses o Develop course structures/syllabi, e.g., course titles, credits, type (clinical or didactic), prerequisites, expected learning outcomes, content, etc. o Develop academic standards, including admission criteria and progression and graduation standards Leadership: Co-chairs one representing UW or community college and one representing clinical partner. Membership: community college, UW, clinical partner and other key stakeholder representatives Voting: A consensus model is being used in RENEW, but if a vote is needed each member of the committee has a vote. Charges/Objectives: o Develop plan for faculty and preceptor development related to didactic and clinical teaching and new active pedagogies, e.g., case-based learning. o Plan nursing education summits o Develop instructional materials, e.g., case studies Leadership: Co-chairs one representing UW or community college and one representing clinical partner. Membership: community college, UW, clinical partner (with representatives from acute care, long-term care and public health) and other key stakeholder representatives Voting: A consensus model is being used in RENEW, but if a vote is needed each member of the committee has a vote. Charges/Objectives: o Develop statewide plan for clinical transformation o Oversee implementation of plan Leadership: Co-chairs - UW and community representatives Membership: community college and UW faculty and student affairs personnel from school and institutional levels Voting: A consensus model is being used in RENEW, but if a vote is needed each member of the committee has a vote. Charges/Objectives: o Develop processes for coadmission and dual enrollment o Develop process to support students financial aid, ADA accommodation, etc. o Develop joint advising processes 7

8 An ambitious but doable Implementation Plan has been developed for RENEW. 1) Year 01 Develop partnership, institutional and curricular structure for development and implementation of a common curriculum. a. With consultant (Dr. Christine Tanner from the Oregon Consortium for Nursing Education), finalize common nursing graduate competencies. b. Establish working committees focusing on curriculum, faculty development, clinical education and student support services. Committees will be composed of representatives from the UW, community colleges, clinical partners, and other key stakeholders as appropriate. c. Establish a faculty/preceptor development plan and host a Nursing Education Summit in spring d. Finalize a full and associate member group through memorandum of understanding. i. Full members will participate in the common curriculum. ii. Associate members will participate in the planning efforts, faculty development, and clinical education transformation, but not the common curriculum. e. Conduct formative evaluation that will provide guidance on development and implementation of common curriculum and achievement of the goals. 2) Year 02 - Develop curricular and clinical education framework and establish student affairs infrastructure for a common curriculum. a. Based on findings from formative evaluation, modify plans as needed. b. With consultant, develop curricular framework for shared curriculum, (e.g., core curricular concepts, prerequisites, nursing courses). c. Develop statewide clinical education model. d. Develop student affairs processes (e.g., admissions, advising, financial aid) to support shared curriculum and student progression from ADN to BSN. e. Implement faculty/preceptor development plan and host the Nursing Education Summit in spring

9 f. Conduct formative evaluation that will provide guidance on development and implementation of common curriculum and achievement of the goals. 3) Year 03 Finalize shared curriculum for implementation in a. Based on findings from formative evaluation, modify plans as needed. b. With consultant, finalize curriculum that outlines admission and progression policies, prerequisite and nursing courses, and scholastic standards. c. Admit first students in fall d. Implement new models of clinical education. e. Continue faculty/preceptor development, based on faculty/preceptor development plan, and host Nursing Education Summit in spring f. Conduct summative evaluation, emphasizing project achievements and lessons learned. Conclusion RENEW aims to revolutionize nursing in Wyoming and nurses and others around the state are excited about the potential of this initiative to transform nursing and health in Wyoming. The initiative brings together a variety of individuals and organizations that were somewhat disconnected in the past to work together to create a shared vision of nursing education. The challenges are significant! But we believe the shared vision, guiding principles, commitment, and the extensive expertise and experience of those involved will help lead to a successful outcome. 9

10 Appendices 10

11 Appendix A RENEW Steering Committee Jennifer Anderson, Laramie County Community College Mary E. Burman, Wyoming Center for Nursing and Health Care Partnerships Carrie Deselms, Wyoming State Board of Nursing Marlene Ethier, Western Wyoming Community College Nancy Hooge, Memorial Hospital of Sheridan County Linette Johnson, Wyoming Public Health Nursing Marilyn Klocksiem, Ivinson Memorial Hospital Kathy Kumer, Castle Rock Convalescent Center Pam Larsen, University of Wyoming, RN-BSN Completion Program Susan Steiner, University of Wyomiong, Basic BSN Program Matt Sholty, Wyoming Center for Nursing and Health Care Partnerships 11

12 Appendix B Wyoming Center for Nursing and Health Care Partnerships Advisory Board and Partners Industry Employers Campbell County Memorial Hospital * Ivinson Memorial Hospital * Wyoming Medical Center * Education and Training Entities Area Health Education Center (AHEC) * Fay W. Whitney School of Nursing * Nurse Educators of Wyoming UW Outreach School* Nightingale Center for Nursing Scholarship (NCNS) Wyoming Geriatric Education Economic Development Wyoming Business Council Workforce Services Wyoming Workforce Development Council Foundations Wyoming Community Foundation * Tate Foundation Veronica Taylor, RN, MS, Infection Prevention/Special Project Manager Jeanine Niemoller, RN, MS, BC Administrator Extended Care Facility Julie Cann-Taylor, RN, MS, Chief Nursing Officer Marivern Easton, Executive Director Mary Burman, Dean of the Fay W. Whitney School of Nursing Jennifer Anderson, RN, MSN, Director of the LCCC School of Nursing Arietta Wiedmann, PhD, Retired Anne Bowen, Director Deborah Fleming, PhD, Director Brandon Marshall, Business and Entrepreneurial Development Program Manager Brad Westby, Industry Partnership Manager Samin Dadelahi, Senior Program Officer Diane Harrop, Board Member 12

13 Professional Organizations Sigma Theta Tau International Lois Pine, RN, MS, President Alpha Pi Chapter Wyoming Hospital Association Dan Perdue, Executive Director Wyoming Medical Society Sheila Bush, Executive Director Wyoming Nurses Association * Faith Jones, RN, MS, President Sue Howard, MSN, RN, Board member Wyoming School Nurses Association Suzey Delger, RN, MS Wyoming State Board of Nursing Mary Kay Goetter, PhD, RN, Executive Director Todd Berger, MSN, APRN, ACNP-BC, Assistant Executive Director Wyoming Department of Employment Tony Glover, Senior Analyst Wyoming Department of Health, Sharla Allen, Manager Office of Rural Health * Wyoming Public Health Nursing Karen Mahan, RN, MPH, Public Health Nurse Advocacy Group AARP Joanne Bowlby Mai, AARP Wyoming Associate Director of Communications Funding Partners (marked with an * if a funding partner and board member) 13

14 Appendix C Oregon Consortium for Nursing Education (OCNE) Consultants Paula Gubrud-Howe, EdD, MS, RN Dr. Chris Tanner, RN, PhD, FAAN Julia Munkvold, RN, MSN Mary Schoessler, RN-BC, EdD, MS 14