Community College Presidents National Meeting on Academic Progression in Nursing Convened by: The Robert Wood Johnson Foundation Hosted at: The American Association of Community Colleges April 9, 2013 Briefing Document (Please read prior to the meeting)
Introduction The Joint Statement on Academic Progression for Nursing Students and Graduates released in September 2012 (enclosure 1) by the American Association of Community Colleges, the American Association of Community College Trustees, the American Association of Colleges of Nursing, the National League for Nursing, and the National Organization for Associate Degree Nursing was an unprecedented show of support for advancing opportunities for academic progression in nursing. More work, however, remains to ensure that nurses in communities around the country have the opportunity to progress academically. Thorough education of nurses will be key to meeting the needs of millions of consumers who will enter the health care system as a result of the Affordable Care Act. The Joint Statement between the nursing community and the American Association of Community Colleges is especially important given the role of community colleges in educating a large number of America s students, and the majority of African American and Hispanic college students. The Robert Wood Johnson Foundation (RWJF) is convening the Community College Presidents National Meeting on Academic Progression in Nursing (APIN) to discuss the needs, issues, challenges, and benefits of pursuing this collaboration to advance academic progression nationally. Meeting participants will explore potential solutions to real-life issues that create barriers to all nurses achieving their full potential in the field. This will include resources for continuing learning, employer sensitivity and support, seamless articulation among educational institutions, and more. We also hope to define a plan of action for promoting academic progression as well as strategies to ensure that the opportunity is available to all students. Meeting Objectives: Thus, the meeting with this select group of community college presidents is intended to address four lofty objectives: identify challenges and opportunities related to academic progression at the community college level; develop strategies and tools to overcome barriers and capitalize on opportunities; engage and support community college presidents as they work to transform education and advance academic progression; and define opportunities for synergy and collaboration between community college presidents and both the Future of Nursing: Campaign for Action (enclosure 2) and the Academic Progression in Nursing (APIN) initiative, where appropriate. Background In 2011, the Institute of Medicine released its report, The Future of Nursing: Leading Change, Advancing Health. This report is a thorough examination of how nurses roles, responsibilities, and education should change to meet the needs of an aging, increasingly diverse population and to respond to a complex, evolving health care system. The recommendations in the report focus on the critical intersection between health needs across the lifespan and the readiness of the
nursing workforce. These recommendations are intended to support efforts to improve health care for all Americans by enhancing nurses contributions to the delivery of care. One of the major recommendations from the report is that nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression (enclosure 3). The report sets the goal of increasing the percentage of the BSNprepared RN workforce to 80 percent by 2020. Clearly, this goal creates many challenges, and achieving it will require a collective effort that includes the entire education community, health employers, nurses already in the workforce, and many others. This is not a new conversation; the qualifications and level of education required for entry into the nursing profession have been widely debated by nurses, nursing organizations, academics, practice partners, and other stakeholders for years. The causal relationship between the RN s academic degree and patient outcomes has been equally debated; however, an increasing number of studies support a significant association between educational level of RNs and outcomes for patients in the acute care setting. But what is the way forward? How do community college nursing programs and BSN nursing programs work more seamlessly to put advanced degrees within reach for many more aspiring and working nurses? How do we make faculty positions of all kinds more appealing to nurses with advanced degrees? How do we encourage advanced practice without diminishing the valuable work of nurses with associate s degrees in nursing (ADNs)? These issues must be part of any reasonable discussion, so that accurate information is available and collaborative progress is possible. After extensive grassroots outreach with nursing education and practice leaders from all 50 states, the Future of Nursing: Campaign for Action, supported by the Robert Wood Johnson Foundation, AARP, and the AARP Foundation, identified four promising models with the potential to accelerate education progression efforts nationwide. Those models are RN-to-BSN degrees awarded from a community college; state or regionally shared competency or outcomesbased curriculum; accelerated options for RN-to-MSN; and shared statewide or regional curriculum. The Robert Wood Johnson Foundation is further supporting the effort to increase the percentage of the BSN-prepared workforce to 80 percent by 2020 through its commitment of $4.3 million in grant money for Academic Progression in Nursing. The American Organization of Nurse Executives, representing the Tri-Council (American Association of Colleges of Nursing, American Nurses Association, American Organization of Nurse Executives, and the National League for Nursing), was selected as the national program office (NPO) for the APIN initiative. The selections of the Tri-Council to lead this work made perfect sense because of their strong, demonstrated commitment to academic progression. The Tri-Council released a consensus policy statement in 2010 on the educational advancement of registered nurses. Key points in the statement include that nurses with advanced education are needed in large numbers to serve as teachers, scientists, primary care providers, specialists, and leaders throughout the health care delivery system. The Tri-Council was compelled to issue this statement following an assessment of how best to prepare nurses for contemporary practice. Participating organizations that represent nurses in practice, research, and academic settings
deliberated on many issues. These included the need to meet workforce demands and prepare nurses for new models of practice; the complexity of the health care environment and patient care needs, and the imperative to address the nurse faculty shortage, which is limiting enrollment capacity in schools of nursing. The Tri-Council encourages all nurses, regardless of entry point into the profession, to continue their education in programs that grant baccalaureate, master s, and doctoral degrees. After a competitive process, in August 2012, nine states were each awarded APIN grants of up to $300,000 over two years to implement and evaluate one or more of the four models noted above. The nine states awarded grants are California, Hawaii, Massachusetts, Montana, New Mexico, New York, North Carolina, Texas, and Washington State. Each state developed a comprehensive action plan that accompanied its grant proposal. During the meeting, leaders from the New Mexico, Texas, and Washington APIN projects will present highlights of the work taking place in their respective states on these academic progression models. Community colleges play a key role in attracting students to the nursing education pipeline. They have an essential charge in ensuring that high quality, affordable nursing education prepares nurses to move on to higher levels of education. Making sure that students are aware of the full range of educational pathways and opportunities available to them is essential not only to achieving the recommendations in the IOM report, but also to providing health care consumers competent, diverse caregivers who are trained to the full scope of their ability. Associate degree nursing educators have been promoting these values for academic progression for years. The president of the National Organization for Associate Degree Nursing (N-OADN) is a member of the APIN Nurse Advisory Council and has been active in promoting academic progression at the community college level with this initiative for over a year. Through this meeting, we hope to ensure that the community college presidents will collaborate in promoting and implementing models for academic progression in nursing going forward. We look forward to a robust and productive meeting. Please come with your thoughts, questions, and enthusiasm. We look forward to our work together on April 9 th. Enclosures (3)
Campaign Overview How will our nation s health care system serve 32 million newly insured Americans? How can we care more efficiently and effectively for the growing numbers of older adults and people with chronic conditions? How can we improve access to health care, quality, and affordability simultaneously? The Future of Nursing: Campaign for Action is tackling these challenges by working to ensure that all Americans will have access to high-quality, patient-centered health care. Formed to implement recommendations from the Institute of Medicine (IOM) report, The Future of Nursing: Leading Change, Advancing Health, the Campaign is an initiative of the AARP s Center to Champion Nursing in America and the Robert Wood Johnson Foundation. Since its inception two years ago, the Campaign has organized 51 Action Coalitions made up of health care providers, consumer advocates, policy-makers, and business, academic, and philanthropic leaders. It is working at the national and state levels to: Transform our health care system by ensuring that nurses have a voice in leadership at all levels on management teams, in boardrooms, and in health care policy debates; Expand access to care by enabling nurses to practice to the full extent of their education and training; Improve the coordination and quality of patient care by advancing interprofessional collaboration among health care professionals; Enable nurses to manage patient care in an increasingly complex system and in diverse settings by strengthening nurse education and training; Promote greater diversity in the profession by encouraging men and women, and people from all racial and ethnic groups, to choose careers in nursing; and Better understand and anticipate health care workforce needs by updating workforce data collection. Achievements The Campaign s progress at the federal and national levels includes: For the first time in its 47-year history, Medicare will pay to support the training of nurses through a $200 million demonstration project in five major hospital systems in Arizona, Illinois, North Carolina, Pennsylvania, and Texas. The Federal Trade Commission has challenged limits to nursing scope-of-practice in Alabama (2010), Tennessee, Texas, and Florida (2011), as well as West Virginia, Louisiana, Missouri, and Kentucky (2012). The Leapfrog Group, for the first time, reported a hospital s Magnet status as an indicator of adequate and competent nursing staff service and nursing leadership at all levels in its 2011 Hospital Survey. (Continued) Revised April 2013
The Campaign, the American Association of Colleges of Nursing (AACN), and the Jonas Center for Nursing Excellence have launched an initiative to increase the number of faculty available to teach in nursing schools. Leaders from national organizations including the American Association of Community Colleges, the Association of Community College Trustees, AACN, the National League for Nursing, and the National Organization for Associate Degree Nursing published a joint statement in support of nursing education. The statement included a shared goal of preparing a well-educated, diverse nursing workforce, and an assertion that nursing students and practicing nurses should be supported in their efforts to pursue higher levels of education. On the state level, Action Coalitions are making progress that includes: Advocacy to remove regulatory barriers to advanced practice registered nurse (APRN) practice and care in 11 states, including Arkansas, Arizona, Connecticut, Florida, Kansas, and Missouri; A unanimous Court of Appeals decision in Colorado to allow certified nurse anesthetists to practice without physician supervision in the state s rural hospitals; Initiatives to strengthen and standardize nursing education classes across schools in Texas, Idaho, and Washington; Research to support IOM education recommendations, including data collection on how to create more seamless transitions from associate s degree (AD) to bachelor of science in nursing (BSN) programs in Indiana; a survey of deans and directors of all 20 nursing education programs in Nebraska; surveys of registered nurses on education and practice in Utah; and a gap analysis of AD BSN competencies in Wisconsin, among others; Interprofessional collaboration in medical and nursing schools in Indiana; A statewide mentorship program to develop nurse leaders in Virginia; and As of February of 2013, 28 states report receiving external funding totalling more than $4.2 million. These grants come from more than 250 institutions and 140 individuals. At the national level, Aetna and United Health Group provided funding to host portions of the National Summit: Transforming Health Care through Nursing. What You Can Do Improve the health and health care of all Americans by becoming involved in the Future of Nursing: Campaign for Action. Join the ranks of health leaders who are applying the knowledge, experience, and insights nurses have to improve patient care. Sign up today and help to change our health care system tomorrow. Learn more at www.campaignforaction.org Get the latest news on Campaign achievements at: http://twitter.com/futureofnursing and/or www.facebook.com/futureofnursing. Revised April 2013