Goals were specifically developed for the Practice Committee

Co-chairs Yvonne Culpepper, DNP RN Cherona J. Hajewski, MSN RN NEA-BC Review the INAC:TH goals specifically related to the Practice Initiatives and Practice Committee Review the Practice committee s substructure inclusive of leadership, members, objectives and actions/progress completed Identify INAC:TH Nursing Practice Committee challenges and priorities to align the Indiana Center of Nursing (ICN) strategic plan and committee structure with INAC:TH Goals were specifically developed for the Practice Committee These Goals were derived from the Institute of Medicine s report on the Future of Nursing: Leading Change, Advancing Health 1

#1-Identify activities to reflect the full scope of nursing practice #2-Maximize utilization of clinical experiences for health related programs statewide #3-Collaborate with partners to review and propose relevant changes to the existing statute and/or rules related to nursing practice #4-Increase funding to support nurses returning for additional education leading to either an APN role or a doctorate Co-Chairs: Yvonne Culpepper, DNP, RN, Vice President, Nursing & CNO, Hendricks Regional Health Cherona Hajewski, MSN, RN, NEA-BC, Vice President, Patient Care & CNO, Deaconess Health System Members: Cindy Adams, PhD, ANP-BC, RN, CNO, Community Health Network Susan Ahrens, PhD, RN, Associate faculty, IUPU-Fort Wayne Bridget Dolohanty-Johnson, MSN, RN, CPNP, Vice President, Patient Care, Parkview Whitley Hospital Linda Q. Everett, PhD, RN, NEA-BC, FAAN, Executive Vice President & CNE, Indiana University Health Kim Harper, MS, RN, Executive Director, Indiana Center for Nursing Marcia Jackson, MSN, MPA, FNP, Nurse Practitioner, Lifecare HIV/Aids Program, IU Health Members (cont.): Barbara Kelly, MSN, FNP-BC, RN, President, ISNA, Director, Koval Center, University of Indianapolis Jan Kirsch, EdD, MSN, RN, Senior Director Performance Improvement VHA Central Bambi McQuade- Jones, DNPc, FNP-C, MSN, Executive Director/Provider, Robert Wood Johnson Foundation Fellow Susan McRoberts, MSN, RN, NEA-BC, Vice President & CNO, Franciscan St. Francis Health Rachael Moody, MS, CNS, RN, Critical Care CNS, Saint Joseph Regional Medical Center Diana Sullivan, MSN, RN, CNOR, Adjunct Clinical Lecturer IUSON Lynn Turner, MSN, RN, Nursing Director, Hendricks Regional Health Katherine Wallace, BA, Director, Performance Improvement, IHA 2

Subcommittee Membership: Leader- Barbara Kelly Members: Marcia Jackson, Rachel Moody, Cornelia Hammerly, Barbara Winningham, Mary Blackburn Objective A-Develop a white paper on reimbursement issues with APRN practice groups related to reimbursement of services Actions Completed or in progress A 25 page white paper on APRN scope of practice and reimbursement issues was completed Aim of the white paper was to serve as a resource & education An Executive summary was developed highlighting main points The white paper was submitted to the INAC:TH Steering Committee in December for review and approval Action completed or in progress: The white paper encompassed 4 groups of Advanced Practice Registered Nurses (APRNs): 1) Certified Nurse Midwife (CNM) 2) Certified Registered Nurse Anesthetist (CRNA) 3) Clinical Nurse Specialist (CNS) 4) Nurse Practitioner (NP) Each APRN group identified issues related to: scope of practice, practice barriers, and reimbursement. All made recommendations to remove these barriers and developed strategies for future recommendations. Actions completed or in progress: White paper recommendations to Removing APRN Practice Barriers: Support the Consensus Model for APRN Regulation-Independent practitioners Negotiate equitable reimbursement for similar services Enforce the any willing provider laws that mandate insurance reimbursement for APRN services Remove barriers that restrict APRNs ability to participate in pay-forperformance/incentive payment Work to identify APRNs (CNM,CNS,NP) as primary care providers Promote provider neutral language in state/federal laws and regulations Allow APRNs admitting and medical staff privileges Develop APRN sensitive quality measures (indicators) similar to NDNQI Educate key stakeholders on the quality and economic value of APRNs 3

Subcommittee Membership: Leader- Bambi McQuade-Jones Members: Diana Sullivan Objective A: Grow the number of clinical preceptors appropriate to fill advanced practice health care worker roles especially in rural health designated setting Action completed or in progress: A survey for APRN s was developed requesting information on precepting barriers Survey was approved by the INAC:TH Steering Committee was sent to the Coalition of Advance Practice Nurses in Indiana (CAPNI) Survey was sent to ISNA for additional APRN responses Survey results are being returned but need to analyzed for precepting barriers Discussed a RWJ grant to trial a precepting model of 1:3 versus 1:1 Subcommittee Membership: Leader- Barbara Kelly. Members: Diana Sullivan, Marcia Jackson, & Katherine Wallace Objective A: Collaborate with partners to propose language for legislative or regulatory consideration as deemed appropriate for this state Actions in Progress: Initially, work on this objective was placed on-hold pending finalization of the APRN white paper Current focus with completion of the white paper is to identify best approach to identify and organize legislative priorities to move this work forward Subcommittee Membership: Leader - Kim Harper Team members: Bridget Dolohanty Johnson Objective B: Identify those organizations that can provide advocacy support and sponsorship Actions Completed and In-progress: Submission of a proposal to RWJF Academic Progression in Nursing: The 21 st Century Challenge to fund state wide plan to increase BSN to 80% by 2020. Proposal was not selected for funding. Grant application for $35,000 submitted to IONE s License Plate Fund requesting financial support for a Summit, INAC:TH work, and data collection. Grant was approved. IONE has provided significant funding to date for the INAC:TH and ICN with a $37,000 grant approved for 2012 and a grant for $35,000 in 2013. 4

Subcommittee Members: Leader- Susan Ahrens Members: Linda Everett, Bridget Dolohanty-Johnson, Katherine Wallace Objective A: Collaborate with Indiana schools and health care employers in exploring strategies to increase the number of nurses returning for advanced education Actions completed: To avoid duplication and overlap with the work of the Education Committee, this subcommittee was dissolved summer, 2012 Subcommittee members: Leader- Cindy Adams Members: Susan Ahrens, Susan McRoberts, Jan Kirsch, Lynn Turner, Cherona Hajewski, Linda Cason, Dawn Scott, Angela Bratina, Lori Hodges, Abbey Camp, Romma Woodward Objective B: Host a task force from education and practice to explore interest in nurse residency programming Actions in Progress: The subgroup is completing work in 3 areas: define content, define preceptor training identify recommendations for divergent ASN and BSN tracks for transition into practice Intent is to design a program using a turnkey approach to be web accessed The model will advocate for seamless education progression Curriculum framework incorporates 6 domains: Leadership, Patient Outcomes, Professional Role, Informatics, Integration into Practice & Profession of Nursing, QI & Safety Processes Sources include: National Council of State Boards of Nursing Transition to Practice Model University Health System Consortium and AACN Nurse Residency Program Versant Residency Program at Children s Hospital, Los Angeles University of Utah Residency Program HCPro Nurse Residency Program Builder CCNE Standards for Accreditation of Nurse Residency Programs INACTH NPC goals: #1-Identify activities to reflect the full scope of nursing practice #2-Maximize utilization of clinical experiences for health related programs statewide #3-Collaborate with partners to review and propose relevant changes to the existing statute and/or rules related to nursing practice #4-Increase funding to support nurses returning for additional education leading to either an APN role or a doctorate INC NPC goals: Practice to full extent of education and training Achieve higher levels of education and training through systems that provide seamless progression Achieve full interdisciplinary partnership in re-designing healthcare delivery Determine other clinical education models Identify other potential partnerships 5

Health care is undergoing a much needed transformation The work of the INAC:TH Practice Committee is committed to meet the growing health care demands and changes by: Removing scope of practice barriers Maximizing clinical experience Creating partnerships to change policy Advancing formal and informal nurse education to lead innovative practice at all levels 1) What are the barriers to patients accessing primary care with the enactment of the Affordable Care Act and expanded Medicaid? 2) What would you identify as potential barriers to the implementation of the Nurse Residency Programming? 6