Future of Nursing: Planning and Progress

Transcription

1 Future of Nursing: Planning and Progress State of the Art April 20, 2015 Marilyn Valerio PhD, RN & Victoria Vinton MSN, RN

2 Faculty Disclosure Today s presenters have no financial interests/arrangements that would be considered a conflict of interest.

3 Objectives Describe the impact of the Institute of Medicine (IOM) 2010 The Future of Nursing: Leading Change, Advancing Health report recommendations on nursing education, leadership, and practice and the importance of the underpinnings of interprofessional practice and diversity. Discuss the role and progress of the NAC in transforming healthcare across the state.

4 National Campaign Vision All Americans have access to highquality, patient-centered care in a health care system where nurses contribute as essential partners in achieving success.

5 Institute of Medicine Report 2010 High-quality, patient-centered health care for all will require a transformation of the health care delivery system

6 Institute of Medicine Report 2010 Enabling nurses to practice to the full level of their training Remove scope-ofpractice barriers. Implement nurse residency programs. Improving nursing education Increase proportion of nurses with a BSN degree to 80% by Double the number of nurses with a doctorate by Ensure that nurses engage in lifelong learning. Preparing and enabling nurses to lead change. Expand opportunities for nurses to lead and diffuse collaborative improvement efforts. Prepare and enable nurses to lead change to advance health. Improving workforce data collection and analysis. Build an improved infrastructure to collect and analyze health care workforce data. Fostering Interprofessional Collaboration Diversity

7 Advancing Education Transformation Removing Barriers to Practice and Care Nursing Leadership Interprofessional Collaboration Diversity DATA

8 Triple Aim Target Population Health Experience of Care Cost

9 From those Who are most central to patient care.

10 It will take. Leadership Vision Experience Direction

11 Nebraska Action Coalition Leading Change, Advancing Health Visiting Nurse Association, Lead Nurse Partner HDR Architecture, Inc., Lead Non-Nurse Partner

12 Executive Committee (1) C. McCullough, L. Lazure, M. Cramer, M. Valerio, J. Lazure, N. Gondringer, D. Kozeny, A. Orduna, L. Walline, D. Straub, L. Connelly, C. Hohnholt Non-Nursing Organization Lead (4) HDR Architecture, Inc. NAC Director (2) V. Vinton Executive Consultant M. Valerio Nursing Organization Lead (5) Visiting Nurse Association Strategic Advisory Committee (3) J. Summerfelt Pres/ CEO VNA C. Benjamin Director AARP-NE L. Redoutey Pres. Nebraska Hospital Association P. Lopez MSN, PHAN J. Ulrich CEO Community Hospital McCook D. Welk, VP Immanuel Tom Frettee, Provider Network Director-NE Medicine Advancing Nursing Education Statewide Team (6) M. Valerio & A. Orduna, Co-Leads L. Connelly & K. Weidner, North Co-Chairs S. Hayek & M. Mertz South Chairs T. Delahoyde & A.Minter East Co-Chairs S. Wilhelm & M. Thomas, West Co-Chairs Advancing Nursing Leadership Statewide Team (7) L. Walline & D. Straub Co-Leads T. Brown-French North Co-Chair C. Wahl & M. Wolf, South Co-Chair P. Agee-Lowrey & D. Ernesti, East Co-Chair C. Jones & L. Schoenholz, West Co-Chair Advancing Nursing Practice Statewide Team (8) N. Gondringer & D. Kozeny, Co-Leads B. Blecher & J. Rystrom, North Co-Chair South Co-Chair D. Conley, East Chair R. Bowman & M. Zimmerman, West Chairs Consultants: J. Lazure & L. Lazure Legislative Consultant: L. Lazure DIVERSITY Interprofessional Collaboration Data/ NE Center for Nursing

13 Mission To improve healthcare access, quality, & cost-effectiveness in a manner that embraces & reflects diversity in Nebraska through collaborative partnerships with consumers, providers, policy makers, & businesses.

14 Vision Transform Leadership. Embrace Diversity. Promote Best Practices. Provide Quality Healthcare.

15 Strategic Action Plan 1. Implement statewide initiative with all schools of nursing to streamline RN to BSN education and achieve 80% BSN by Support removal of practice barriers for Nebraska nurse practitioners to assure accessible primary care across the state Click here for website 3. Lead statewide efforts to diversify the RN workforce in Nebraska to meet affordable, accessible healthcare for our growing minority population 4. Prepare and promote nurses for leadership on community and hospital board membership

16 WORKFORCE DATA ISSUES

17 What We Are & What We Are Not Consumer partners not just nursing Catalyst organization not umbrella Self-sustainability essential Interprofessional collaboration a must Coalition of internal/external stakeholders

18 Education Team 80% BSN by 2020 Double Doctorates Transition to Practice Interprofessional Education

19 Nursing Research Influences Policy and Practice Practice in acute care organizations Shaped state health policy. Informed national health guidelines and standards. Informed national health policy through federal agencies, congressional testimony, and Institute of Medicine citations. Shaped health science policy.

20 Education Evidence Studies show association between higher nurse education level and improved health care outcomes. Studies show higher proportions of BSN-prepared nurses associated with lower rates of medication errors, mortality, and failure to rescue Research also shows with BSN-preparation stronger diagnostic skills and better intervention evaluation Growing body of research shows a connection between baccalaureate education and lower mortality rates.

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23 Interprofessional Collaboration

24 U.S. Health Care Workforce RNs 2,600,000 MDs 878, 194 Pharm Ds 281,560 NPs 105,780 PTs 184,000 PAs 83,640

25 NAC Response to Interprofessional Collaboration We need to better understand what interprofessional collaboration looks like? Engaging others Intra Inter Consumers-client/population centered

26 Practice Team LB 107 Rules & Regs Workforce Transition to Practice All nurses practice to full education/training

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29 Disparities in Life Expectancy by Zip Life Expectancy at Birth Median Household Income Poorest Zip Code in Omaha Codes Richest Zip Code in Omaha Zip Code of in Scottsbluff, NE 70.6 years 82.6 years 76.9 years $ 23, 470 $ 90,263 $37,967 White (%) Black (%) Poverty (%) Unemployment Rate (%) Source: Su, Dejun (UNMC Center for Reducing Health Disparities) and NE DHHS (2015).

30 Improve Workforce Diversity Nurses should reflect the population in terms of gender, race and ethnicity. Recruit the nursing workforce of the future. All nurses should provide culturally responsive services and care. Greater workforce diversity may help to reduce health disparities.

31 Nursing Diversity in Nebraska African American/Black Asian/Pacific Islander Caucasian/White Native American Hispanic Other

32 2013 U.S. Census NE Racial/Ethnic Diversity 2013 U.S. Census NE Racial/Ethnic Diversity White Hispanic African American Asian Native American Others

33 Men in Nursing NE (2012)

34 Leadership Team 40 under 40 Nurses Champion Employers Mentors 10% increase nurses on boards

35 Promote Nurse Leadership Nurses bring a unique perspective to management and policy discussions. Nurses spend the most time with people receiving health services. Nurses are the largest segment of the health care work force. Nurses are vital to improving quality. Yet nurses account for only 6 percent of hospital board positions.

36 2020: 10,000 nurses on boards WHY NURSES? Innovative Collaborative Well honed listening/interview skills Recognize need for interprofessional roles Effective team member Patient advocate Strive for honesty, transparency, & integrity Value connection between community & healthcare

37 If we re not at the table we re on the menu Nurses most trusted profession for over a decade. (Gallup, 2014) Opinion health leaders note barriers to nurses increased influence & leadership Not perceived as important decision makers Not revenue generators (directly) Don t have single voice on national issues Solution: Nurses need to Lean In

38 Power of Coalitions The power of coalitions lies in their ability to bring people together from diverse perspectives around clearly defined purposes to achieve common goals. Strength lies in numbers in working together and strategizing for success. Like us Mason, et al.

39 Robert Wood Johnson Foundation Visiting Nurses Association* HDR Architecture, Inc* Immanuel* Saint Elizabeth Regional Medical Center* Nebraska Hospital Association St. Francis Medical Center Grand Island* Good Samaritan Hospital Kearney* Nebraska Medical Center* University of Nebraska College of Nursing* NONL* and NONL District III Executive Committee of NAC* Creighton University College of Nursing* Alegent Creighton Health Aureus Medical, affl of C&A Industries* NE Assembly of Nursing Deans and Directors* Great Plains Medical Center North Platte Methodist Hospital* Nebraska Nurses Association Columbus Community Hospital* Nebraska Association of Nurse Anesthetists* Nebraska Nurse Practitioners* Clarkson College* Community Hospital McCook* Nebraska Emergency Nurses Association Donor-members of NAC* AARP-Nebraska Chapter* NNA District 2 Nebraska Nurse Midwives Equitable Bank Foundation Grand Island* AWHONN NE League for Nursing* Heartland Gerontological Nurse Assc* Nebraska Methodist College Five Points State Bank G.I. American Psychiatric Nurses Assc (NE) AORN Nebraska School Nurse Association *Repeat donors

40 Please join us in this important work! For more information, contact: Victoria Vinton, MSN, RN Director, Nebraska Action Coalition Call:

41 References Blegen, M., Good, C., Park, S., Vaughn, T., & Spetz, J. (2013). Baccalaureate Education in Nursing and Patient Outcomes. Journal of Nursing Administration, 43(2): Enhancing Diversity in the Workforce (2014). Retrieved April 6, IOM (Institute of Medicine) The Future of Nursing: Leading Change, Advancing Health. Washington D.C. The National Academies Press. Joynt, K., Orav, E.J., & Jha, A. Mortality Rates for Medicare Beneficiaries Admitted to Critical Access and Non-Critical Access Hospitals, JAMA. 2013; 309(13): Khoury, C.M. and Blizzard, R. (2011). Nursing leadership from bedside to boardroom: A Gallup national survey of opinion leaders. JONA, 41 (7/8), Mason, D. J., Leavitt, J. K., & Chaffee, M. W. (2011). Policy & politics for nursing and health care (6th ed.). St. Louis, MO: Elsevier Saunders. (p. 626). Newhouse, R.P., et al. A Phased Cluster-randomized Trial of Rural Hospitals Testing a Quality Collaborative to Improve Heart Failure Care: Organizational Context Matters. (2013). Medical Care, 51(5): Pribil, L. (2009). Engaging Nurses in Governing Hospital and Health Systems. Journal of Nursing Care Quality 24(1):5-9. RWJF. (2014). Building a Culture of Health Retrieved: March 30, Sandberg, S. (2013). Lean In: Women, Work and the Will to Lead. Alfred A. Knopf, New York.