Victoria Folse, PhD, APN Director & Professor, School of Nursing, Illinois Wesleyan University Caroline F. Rupert Endowed Chair of Nursing Vice-Chair, Illinois Association of Colleges of Nursing Donna Meyer, MSN, RN Dean of Health Sciences, Lewis and Clark Community College President, Organization for Associate Degree Nursing
Presentation Objectives Discuss national initiatives to advance the future of nursing and increase the proportion of nurses with baccalaureate degrees by 2020 Evaluate Illinois progress on increasing the proportion of nurses with baccalaureate degrees through ICCB and IACN partnerships to strengthen seamless academic progression
FUTURE OF NURSING: KEY MESSAGES Practice to the full extent of our education and training; Achieve higher levels of education and training; Be full partners in redesigning health care in the United States; Improve data collection.
FUTURE OF NURSING Recommendations 3-6 relate to education progression in nursing (IOM, 2010) Implement nurse residency programs(3); Increase the proportion of nurses with a baccalaureate degree to 80 percent by 2020(4); Double the number of nurses with a doctorate by 2020(5); Ensure that nurses engage in lifelong learning(6)
BACKGROUND AND SIGNIFICANCE: Who is Practicing Nursing Percentage of nurses and highest degree achieved: Diploma 15.5% Associate Degree in Nursing 37.2% Baccalaureate of Science in Nursing or higher 55% The U.S. Nursing Workforce: Trends in Supply and Education Health Resources and Services Administration National Center for Health Workforce Analysis April 2013
AARP S CAMPAIGN FOR ACTION National initiative to guide implementation of the recommendations in The Future of Nursing: Leading Change, Advancing Health Coordinated through the Center to Champion Nursing in America (CCNA), an initiative of AARP, the AARP Foundation and the Robert Wood Johnson Foundation (RWJF).
RWJF ACADEMIC PROGRESSION IN NURSING ADVISORY (APIN) COMMITTEE Funded by the Robert Wood Johnson Foundation (RWJF), to advance state and regional strategies to create a more highly educated nursing workforce
JOINT STATEMENT ON ACADEMIC PROGRESSION Released September 18, 2012 American Association of Community Colleges Association of Community Colleges Trustees American Association of Colleges of Nursing National League for Nursing Organization for Associate Degree Nursing January 6, 2014, Endorsed by the American Nurses Association
The number of bachelor s prepared RN candidates doubled from 2001 2011 Non-bachelor s prepared RN candidates constitute the majority of all RN candidates 60 percent in 2013 28,000 RN s were awarded a post-licensure bachelor s in nursing (RN-BSN) in 2011 Currently, 55% of the registered nurses have a BSN degree
ADVANCING ACADEMIC PROGRESSION Promising Solutions Shared statewide or regional curriculum Seamless progression Community colleges granting BSN degrees RN-to-MSN programs
RN-TO-MSN PROGRAM Offers shorter timeline to completion than traditional BSN or MSN programs Driven by more AD graduates returning to school to obtain MSN without BSN Values practice experience of AD nurses Seamless, university-based program that emphasizes practice components 173 programs available in 39 states Easier to implement than other models
DISINCENTIVES TO RETURN TO SCHOOL Personal Barriers o Advancing age o Multiple role strain o Limited resources o Lack of confidence o Low expectations
DISINCENTIVES TO RETURN TO SCHOOL Academic Institutional Barriers o Cost of education o Redundant curriculum o Not counting previous learning or experience o Lack of flexibility with scheduling o Faculty not responsive to needs of adult learner o Lack of effective advising o Geographic constraints o Lack of socialization into academic program o Changing requirements o Negative experience with undergraduate education
DISINCENTIVES TO RETURN TO SCHOOL Health Service Institution Barriers o Lack of financial assistance o Lack of flexibility o Lack of incentives to earn BSN o Lack of effective partnering with academic institution
ISSUES RELATED TO THE 80/20 Retirement Cliff 30 million more Americans with healthcare insurance Faculty shortage decreasing educational capacity o 79,659 qualified applications turned away to all professional nursing programs in 2012 o 14,354 qualified applications were turned away from graduate programs in 2011 ¾ million RNs need to return to school to reach the recommendation of 80/20
STRATEGIES FOR A BETTER EDUCATED NURSING WORKFORCE For Academia
STRATEGIES FOR ACADEMIC SEAMLESSNESS Beyond articulation = seamlessness o Can students be dual-enrolled? o Do all the pre-requisites align? o Are ADN/diploma students required to take more units? o Are students appropriately counseled? o Is the BSN program s GPA out of reach for RNs? o What is the mechanism to eliminate curriculum redundancy? o Will there be a mechanism to give RNs credit for their previous knowledge and experience?
STRATEGIES FOR A BETTER EDUCATED NURSING WORKFORCE For Health Service Organizations o Increase monetary incentives for earning a more advanced degree in nursing Pay differential Clinical ladder Up front tuition reimbursement & stipends to reduce work hours Make it Possible o Consistent and flexible scheduling o Cohort on-site model Make it Desirable o Create culture of appreciating evidence based practice and academia o Position role models
ICCB and IACN Partnership Joint Meetings to Date February 7, 2013 September 27, 2013 June 12, 2014
ILLINOIS HEALTHCARE ACTION COALITION (IHAC) AIMS I. Illinois will foster a well-educated workforce prepared to meet future healthcare demands II. Illinois will advance inter-professional collaboration across the health spectrum III. Nurses will practice to the full extent of their education and training IV. Nurses will strengthen leadership skills at all levels V. Illinois will gather and generate data for program performance measures and outcomes to make informed decisions
ICCB/IACN JOINT FOCUS TO SUPPORT IOM S FUTURE OF NURSING INITIATIVES Develop ADN-BSN partnerships Promote Standardized Curriculum Promote transition from ADN-BSN Statewide mandatory accreditation for all nursing programs across the state Need for a standardized application process ICCB and IACN should continue collaborating Open dialogue among all nursing programs
SEAMLESS EDUCATION Received the most Top Priority Votes through a World Café Exercise 20 out of 27 members wanted to focus on a Standardized Curriculum
SEAMLESS EDUCATION BARRIERS Need for regulatory agencies to work with standardized curriculum Competition among programs Lack of standardization (e.g., expiration of science courses) Absence of comprehensive database for all programs and requirements Uncertainty regarding school-wide administrative support
BUILDING CLINICAL PARTNERSHIPS Dedicated Educational Units Host transition to practice consortium/ readiness Agreements with clinical agencies to provide clinical faculty Preceptor-based model for clinical Providing staff education Illinois to take a stand against payment for clinical opportunities
CLINICAL PRACTICE CHALLENGES Identify alternative clinical sites (e.g., community) and/or delivery models (e.g., simulation) Develop interprofessional clinical opportunities Reconsider changing needs for specialty clinical sites (e.g., Peds, OB, Mental Health) Dialogue with clinical agencies regarding student clinical needs
PROPOSED ADN CURRICULUM Supported by approx. 75% Deans/Directors who responded Anatomy and Physiology and lab (8 semester hours) Microbiology (4 semester hours) Introduction to Psychology (3 semester hours)* Developmental Psychology (3 semester hours)* English Composition (3 semester hours) English II: Speech (3 semester hours)* Approx. 38-40 hours of nursing will transfer Total: 62-64 semester hours to transfer to BSN Completion
ADDITIONAL COURSES PROPOSED Math/Statistics 10 Chemistry 7 Sociology 6 Nutrition 6 Humanities 3 Intro to Computers 2 Survey data from IACN and ICCB Deans collected and analyzed by Linda Roberts, Manager, Illinois Center for Nursing
IHAC PROPOSED STANDARDIZED ADN CURRICULUM LACKS THE FOLLOWING FROM IAI English (3 SH) Math (3 SH) Sociology/Behavioral Science (3 SH) Humanities (9 SH) Cultural diversity (3 SH)
PROPOSED RN to BSN CURRICULUM (first draft under consideration) Nursing Concepts & Theories (3) Community Health Nursing (3) o Community Health Clinical (3) Leadership & Policy (3) o Leadership Clinical (3) Health Assessment (3) Research (3) Statistics (3) Ethics (3) Informatics (3) consider threaded throughout 27 Semester hours are recommended. If 62-64 hours are transferred in, then each school would add an additional 29-31 hours to meet the required 120 hours for a BSN degree
CHALLENGES TO ICCB-IACN PARTNERSHIPS The degree to which Deans and Directors are empowered to make decisions The degree to which Deans and Directors involve faculty and staff colleagues in curricular decision making The financial incentives by Board of Trustees and University Presidents to expand existing offerings (e.g., Baccalaureate degrees at community colleges)
Continue discussion on RN-BSN curriculum while being mindful of proposed standardized curricula for ADN programs Repeat survey to determine degree of support for RN-BSN standardized curriculum Monitor community college response to reducing hours to 60 and success of baccalaureate programs limiting hours to 120 Consider AA versus AS challenges as well as IBHE requirement of 30 upper division credit hours
ADDITIONAL THOUGHTS Illinois ADN-BSN practice partnerships model collaborative practice IACN/ICCB open dialogue consistent with 2012 Joint Statement on Academic Progression IACN/ICCB joint efforts have the potential to advance the Future of Nursing endeavors regarding nursing education Need to keep this at the forefront with current IL legislative priorities focused on APN practice and Nurse Practice Act revision
COMMENTS AND QUESTIONS
CONTACT INFORMATION Victoria N. Folse vfolse@iwu.edu 309-556-3286 Donna Meyer dmeyer@lc.edu 618-468-4400