BUILD UPON YOUR NLCP EXPERIENCE THROUGH ACADEMIC PROGRESSION Dr. Colleen Manzetti, CNE, CNLCP Assistant Professor & Graduate Faculty Monmouth University 1
LEARNING OBJECTIVES: 1. The participants will describe academic progression. 2. The participants will analyze the current professional climate regarding academic progression and predict the potential impact on the NLCP. 3. The participants will debate the need to advance the educational requirements of a NLCP. 4. The participants will discuss the various routes to bridge their current educational qualification to meet the initiatives of the 2010 IOM report The Future of Nursing: Leading Change, Advancing Health. 2
THE FUTURE OF NURSING: LEADING CHANGE, ADVANCING HEALTH 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 by providing an action-oriented blueprint for the future of nursing. 2010- Release of this landmark report http://iom.nationalacademies.org/reports/2010/the-future-of-nursing-leading-change-advancing-health.aspx IOM s most downloaded document every month since its original issuance date. 3
THE NEED FOR A FUNDAMENTAL TRANSFORMATION OF THE NURSING PROFESSION Nurses have a crucial role Quality Accessibility Value of care The ways in which nurses were educated during the 20th century are no longer adequate for dealing with the realities of health care in the 21st century. Care is more complex These competencies include: leadership health policy system improvement research evidence-based practice teamwork collaboration information management care coordination 4
REFORMED HEALTH CARE SYSTEM Affordable Care Act Patient Protection and Affordable Care Act (P.L. 111-148) passed in the senate on December 24, 2009 passed in the house on March 21, 2010 Signed into law by President Obama on March 23 rd, 2010 Upheld in the supreme court on June 28, 2012 As the Affordable Care Act moves toward an emphasis on prevention and management rather than acute care Nursing competencies will dominate in a reformed health care system (O Neil, 2009). 5
REFORMED HEALTH CARE SYSTEM Nursing competencies care management and coordination transitional care patient education public health intervention New Nursing competencies: systems thinking quality improvement care management health policy research 6
THE FUTURE OF NURSING: LEADING CHANGE, ADVANCING HEALTH 4 Key messages: 1. Nurses should practice to the full extent of their education and training. 2. Nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression. 3. Nurses should be full partners, with physicians and other health care professionals, in redesigning health care in the United States. 4. Effective workforce planning and policy making require better data collection and information infrastructure. 7
8 RECOMMENDATIONS: 1. Remove scope-of-practice barriers. 2. Expand opportunities for nurses to lead and diffuse collaborative improvement efforts. 3. Implement nurse residency programs. 4. Increase the proportion of nurses with a baccalaureate degree to 80 percent by 2020. 5. Double the number of nurses with a doctorate by 2020. 6. Ensure that nurses engage in lifelong learning. 7. Prepare and enable nurses to lead change to advance health. 8. Build an infrastructure for the collection and analysis of interprofessional health care workforce data. 8
INCREASE THE PROPORTION OF NURSES WITH A BACCALAUREATE DEGREE TO 80 PERCENT BY 2020. 1. The Commission on Collegiate Nursing Education (CCNE), working in collaboration with the National League for Nursing Accrediting Commission (NLNAC), should require all nursing schools to offer defined academic pathways, beyond articulation agreements, that promote seamless access for nurses to higher levels of education. Nursing is unique among the health care professions in the United States because it has multiple educational pathways leading to an entry-level license to practice. bachelor s of science in nursing (BSN) associate s degree in nursing (ADN) diploma in nursing completion programs for Licensed Practical Nurses accelerated, second-degree bachelor s program (possess a baccalaureate degree in another field) community college-based baccalaureate programs entry-level master s programs (undergraduate degrees in fields other than nursing) 9
MORE EDUCATED NURSING WORKFORCE Care within the hospital continues to grow more complex critical decisions associated with care for sicker, frailer patients use more sophisticated, life-saving technology information management systems require skills in analysis and synthesis Care outside the hospital Also becoming more complex Coordinate care among a variety of clinicians and community agencies manage chronic illnesses, thereby preventing acute care episodes and disease progression; use a variety of technological tools to improve the quality and effectiveness of care 10
DEFINED ACADEMIC PATHWAYS Articulation Agreements formal agreements between two or more Colleges and Universities Document the transfer policies for a specific academic program or degree Diploma ADN Academic Pathways seamless access dual enrollment integrated curriculum cost effective 11
INCREASE THE PROPORTION OF NURSES WITH A BACCALAUREATE DEGREE TO 80 PERCENT BY 2020. 2. Health care organizations should encourage nurses with associate s and diploma degrees to enter baccalaureate nursing programs within 5 years of graduation by offering tuition reimbursement, creating a culture that fosters continuing education, and providing a salary differential and promotion. Employers 5 years to achieve a BSN 5 years to earn a Masters or Doctoral degree if holding an manager/ administrative position Magnet Status Hospital Associations Evidence Based Practice to support improved outcomes 10% increase in the proportion of hospital staff nurses with baccalaureate degrees is associated with a 5% decline in mortality following common surgical procedures BSN-prepared nurses improve patient outcomes-follow-up study confirming Aiken LH, Clarke SP, Cheung RB, Sloane DM, Silber JH. Educational levels of hospital nurses and surgical patient mortality. JAMA. 2003;290(12): 1617-1623. Aiken LH, Clarke SP, Sloane DM, Lake ET, Cheney T. Effects of hospital environment on patient mortality and nurse outcomes. Journal of Nursing Adm. 2008;38(5):223-229. 12
SUPPORTERS FOR ADVANCING EDUCATION National League for Nursing (NLN) American Nurses Association (ANA) American Organization Nurse Executives (AONE) American Association of Community Colleges National Organization for Associate Degree Nursing American Association of Colleges of Nursing (AACN) American Nurses Credentialing Center (ANCC) 13
AMERICAN NURSES CREDENTIALING CENTER (ANCC) Subsidiary of the American Nurses Association (ANA) longstanding position that baccalaureate education should be the standard for entry into professional nursing practice Mission of ANCC: promote excellence in nursing and health care globally through credentialing programs. validate competence through exams Distinguish between the nurse with a BSN who will earn a "board certified" credential and the associate's degree or diploma nurse, who will earn the "certified" designation. 14
THE TRANSITION TO A NATIONAL BSN NURSE WORKFORCE Market Forces Economic downturn has postponed retirement of RN Difficult for new RN s to get hired Employers requiring ADN & Diploma RN s to be enrolled in an RN- BSN program upon hiring with 5 years to complete The Future of Nursing: Campaign for Action a joint initiative of AARP and RWJF promote more efficient articulation between associate degree and baccalaureate nursing programs Assist state Action Coalitions develop local and regional strategies to increase the number of nurses with BSNs 15
MAGNET RECOGNITION Voluntary accreditation for nursing excellence Require evidence from applicants documenting progress toward achieving a nursing workforce of at least 80 percent BSNs 2004 only 35,000 nurses pursued a BSN 2015 more than 100,000 nurses are pursuing a BSN 16
COMMITTEE FOR ASSESSING PROGRESS ON IMPLEMENTING THE RECOMMENDATIONS OF THE IOM REPORT 2015 Progress Report Key message: Achieving Higher Levels of Education Conclusions: As the RN population shifts to becoming increasingly baccalaureate-prepared, unintended consequences for those nurses who do not achieve higher education may occur. Employment Earning power Skills Roles and Responsibilities 17
COMMITTEE FOR ASSESSING PROGRESS ON IMPLEMENTING THE RECOMMENDATIONS OF THE IOM REPORT 2015 Progress Report Key message: Achieving Higher Levels of Education Recommendations: Continue Pathways Toward Increasing the Percentage of Nurses with a Baccalaureate Degree. The Future of Nursing: Campaign for Action, the nursing education community, and state systems of higher education should continue efforts aimed at strengthening academic pathways for nurses toward the baccalaureate degree: entry-level baccalaureate programs baccalaureate completion programs 18
COMMITTEE FOR ASSESSING PROGRESS ON IMPLEMENTING THE RECOMMENDATIONS OF THE IOM REPORT Achieving Higher Levels of Education Important pathways for diverse and disadvantaged students to enter the nursing profession: Community colleges associate s degree programs Baccalaureate completion programs Provide educational pathways Maintained Strengthened 19
NURSE LIFE CARE PLANNER Mission The mission of AANLCP is to support the nursing community to achieve excellence in the practice of nurse life care planning. This is accomplished by providing the fluid exchange of information and an opportunity for lifelong learning through the promotion of education, collegiality, collaboration, research, and standards of practice. Core Values Competence Integrity Accountability Objectivity Respect for human dignity American Association of Nurse Life Care Planners (AANLCP ) CNLCP Certification Board 20
NURSE LIFE CARE PLANNER American Board of Nursing Specialties and the Accreditation Board for Specialty Nursing Certification Support the IOM recommendations for the BSN The CNLCP Certification Board is in the process of obtaining accreditation through the Accreditation Board for Nursing Specialty Certifications Research to support the specialty practice 21
NURSE LIFE CARE PLANNER Expert Qualified Hired for services Court Questions for qualifying: Background Education Experience Knowledge Education and degrees are often highly regarded as evidence of expertise (Powell,2013 pg 113) 22
NURSE LIFE CARE PLANNER Number of BSN nurses are increasing 2012 CNLCP Certification Board Role Delineation Study of NLCP N=133 highest degree of education 39% BSN 21% ADN 10% Diploma 11% Masters <1% Doctoral 23
HOW TO MOVE ALONG THE EDUCATION CONTINUUM The NLN and AACN are both strong supporters of academic progression formal, degree-granting programs lifelong-learning experiences Program options: BSN degree-completion programs for RNs Masters Doctoral New Program options: RN-BSN RN-MSN Direct baccalaureate to doctoral programs research-focused terminal degree 24
HOW TO MOVE ALONG THE EDUCATION CONTINUUM New Program options: RN-BSN Nursing classes focus on leadership, research, etc. General Educations RN-MSN Nursing focus General Educations requirements by passed because getting higher degree Integration of a general liberal education with professional learning and activity. Direct baccalaureate to doctoral programs research-focused terminal degree 25
MOVING ALONG THE EDUCATION CONTINUUM Various delivery Systems: Traditional programs-face to Face (F2F) Colleges & Universities Offsite locations Academic-service partnerships Hybrid Education Management System Half course is online Half is face 2face Online Education Management System Simulation Distance learning 26
CONTACT INFORMATION Dr. Colleen Manzetti, CNLCP, CNE Assistant Professor and Graduate Faculty Monmouth University Marjorie K. Unterberg School of Nursing and Health Studies 400 Cedar Avenue West Long Branch, NJ 07764 Office-732-923-4550 Cell: 732-261-1761 cmanzett@monmouth.edu RN BSN http://www.monmouth.edu/school-of-nursing-health/rn-to-bsn.aspx RN TO MSN http://www.monmouth.edu/school-of-nursing-health/rn-to-msn-direct.aspx MSN http://www.monmouth.edu/school-of-nursing-health/master-of-science-in-nursing.aspx Doctor of Nursing Practice http://www.monmouth.edu/school-of-nursing-health/doctor-of-nursing-practice-(dnp).aspx 27
REFERENCES References AARP. 2010. Preparation and roles of nursing care providers in America. http://championnursing.org/resources/preparation-and-roles-nursingcare-providers-america (accessed August 17, 2010). Aiken LH, et al. 2014. Association of nurse staffing and education with hospital mortality in 9 European countries. The Lancet 383:1824-30. Aiken LH. 2014. Baccalaureate nurses and hospital outcomes: More evidence. Medical Care. 52:861-863. Aiken LH, Clarke SP, Cheung RB, Sloane DM, Silber JH. Educational levels of hospital nurses and surgical patient mortality. JAMA. 2003;290(12): 1617-1623. Aiken & Yakusheva (2014) BSN Qualifications Recommended for the Nation s Nurses: Four Years of Progress. Retrieved at http://www.rwjf.org/en/culture-of-health/2014/10/bsn_qualificationsr.html Aiken LH, Clarke SP, Sloane DM, Lake ET, Cheney T. Effects of hospital environment on patient mortality and nurse outcomes. J Nurs Adm. 2008;38(5):223-229 Assessing the Progress on the Institute of Medicine Report The Future of Nursing (2015). Retrieved from: http://iom.nationalacademies.org/reports/2015/assessing-progress-on-the-iom-report-the-future-of-nursing American Association of Nurse Life Care Planners. Retrieved from: http://www.aanlcp.org/?page=missionstatement HRSA (Health Resources and Services Administration). 2010. The registered nurse population: Findings from the 2008 National Sample Survey of Registered Nurses. Rockville, MD: HRSA. Kutney Lee, A, Sloane, DM, Aiken, LH. 2013. Increases in nurses with baccalaureate degrees associated with lower rates of post-surgery mortality. Health Affairs 32(3):579-586. O Neil, E. 2009. Four factors that guarantee health care change. Journal of Professional Nursing 25(6):317-321 Powell, V. (2013) Qualifying as an expert witness. American Journal of Nurse Life Care Planning. 13 (3) pg112-122 "Summary." Institute of Medicine. The Future of Nursing: Leading Change, Advancing Health. Washington, DC: The National Academies Press, 2011. doi:10.17226/12956 U.S. Census Bureau. 2009. Table 603. Employed civilians by occupation, sex, race, and Hispanic origin: 2008. In Statistical abstract of the United States: 2010. 129th ed. Washington, DC: U.S. Census Bureau. Yakusheva O, Lindrooth R, Weiss, M. 2014. Economic evaluation of the 80% baccalaureate workforce recommendation: A patient-level analysis. Medical Care 52:864-869. 28