Educational Challenges Changing Roles

1. Educational ChallengesChanging Roles

2. E-Line Military

3. Diversity in NursingMales • Facts • 11.4% of pre licensure students are male • 9% of DNP students are male • 7.5% of PhD students are male • 6.2% are practicing nurses are male • Many are in the military • Issue • Few role models and mentors • Duke’s model

4. Ethnic Diversity in Nursing

5. Changes in Nursing Education • Competency-based curricula • Community colleges moving rapidly toward teaching concepts over the curriculum and not block courses. • Examples • Reduction in credit hours for both the Associate degree and the BSN • Associate degree to 60 hours • BSN to 120 hours • Attempt to standardize the prerequisites.

6. Changes in Nursing Education • Curriculum–major areas of focus in a “new” nursing education curriculum should include interprofessional collaboration, communication, and systems thinking. • Life-long learning–nurses must keep up with new knowledge and new technology to ensure quality patient care.

7. Changes in Nursing Education • Technology–simulations and other types of technology that encourage critical thinking and problem solving are important to adequately prepare the required number of nurses for the future. • Articulation–curricula and educational programs should be structured to enable the learner to progress from basic to advanced education with minimal disruption.

8. Changes in Nursing Education • Older adult care–given the shift in age range of the population of the United States, significant time and emphasis must be allocated to student learning about geriatric care, management of chronic conditions, and community-based practice. • Technology–simulations and other types of technology that encourage critical thinking and problem solving are important to adequately prepare the required number of nurses for the future.

9. Changes in Nursing Education • Articulation • Professionalism – nursing education must include empowering students to be active players in the healthcare environment

10. Changes in Nursing Education Carnegie Report (Patricia Benner) • Nursing education in the traditional formats is not working to prepare nurses to practice in today’s complex healthcare environment.

11. Changes in Nursing Education • Recommendations • Better Articulation between programs • the curricula currently used by schools of nursing, focusing on performance of nursing tasks or skills, must be significantly changed. • Focus of undergraduate education should be on development of knowledge, skills, and abilities to function in a complex healthcare system. • Students entering nursing today need to be knowledgeable about topics such as leadership, cultural diversity, advocacy, and evidence- based practice. • Residency Programs

12. Interprofessional Collaborative Care • The effect of Interprofessional Care Teams on Intensive Care Unit Mortality • Likelihood of Death within 30 Days of ICU Admission • ICUS without daily Interprofessional Rounds 19.1% • ICUS with daily Interprofessional Rounds 16.2% • A study of critically ill patients admitted to 1169 Pennsylvania hospitals over the course of two years found that daily rounds by an interprofessional ICU team were associated with a significantly reduced risk of death.

13. Conventional VS Collaborative Care Conventional • Authoritarian • Autonomous practice culture • Physician Driven, MD’s responsible for outcomes • Episodic, fragmented • Primary Care delivered in one size fits all 15 min • Payment based on quantity (fee for service) • Reactive, Focused on illness • Communication is inconsistent Collaborative Care • Collaborative • Team Culture • Patient centered, with team members sharing responsibility for outcomes. • Continuous, coordinated • Primary care delivered via ind. Visits, phone calls, and online communications • Payment based on value • Preventive, focused on health • Communication is imperative

14. Core Competences for IPC • Values/ethics for Interprofessional Practice • Mutual respect • Shared values • Roles/Responsibilities for Collaborative Practice • Use knowledge of one’s own role and those of other professions • Assess and address the health care needs of patients and populations served. • Interprofessional Communication • Communicate with patients, families, communities, and other health professional in a responsive and responsible manner that supports a team approach in maintenance of health and treatment of disease • Interprofessional Teamwork and Team-Based Care

15. Interprofessional Teamwork • Interprofessional Teamwork and Team-Based Care • Apply relationship –building values and the principles of team dynamics to perform effectively in different health roles to plan and deliver patient population centered care that in ss safe, timely, efficient, effective , and equitable.