Equip & Empower for Educational Transformation: Getting to 80% BSN by 2020

1. Equip & Empower for Educational Transformation: Getting to 80% BSN by 2020 A Webinar for Midwestern States and Their Leaders July 7, 2011

2. Welcome Susan Reinhard, PhD, RN, FAAN Senior Vice President, AARP Public Policy Institute Chief Strategist, Center to Champion Nursing in America

3. During Today’s Webinar • Review CCNA’s work on education • Overview of the Future of Nursing: Campaign for Action • Transforming nursing education • Q&A • Next steps

4. 30 state teams • Two national summits • Oregon site visit • State team leader convening

5. Susan Hassmiller, PhD, RN, FAAN,Robert Wood Johnson Foundation Senior Adviser for Nursing

6. Campaign Vision • All Americans have access to high-quality, patient-centered care in a health care system where nurses contribute as essential partners in achieving success

7. Campaign for Action

8. Education

9. Education • Evidence • Significant association between educational level and patient outcomes • 6 percent of AD grads get advanced degree, enabling them to teach and serve as PCPs, compared to 20 percent of BSN grads

10. Campaign for Action

11. Campaign for Action State Involvement WA ME MT ND OR MN VT ID NH SD WI NY MA WY MI RI IA PA CT NV Map Legend Action Coalition State State Involvement NE NJ IN OH UT DE IL MD CA CO WV VA KS MO KY DC NC AZ TN OK NM AR SC GA MS AL TX LA AK FL HI UPDATED: 6.6.2011

12. Learn More by Visiting: http://thefutureofnursing.org/ http://championnursing.org/ Like us on Facebook and join the conversation at www.facebook.com/championnursing Follow us on Twitter at www.twitter.com/championnursing.

13. The Case for National Nursing Workforce Data Linda Tieman RN MN FACHE President, Board of Directors National Forum of Nursing Workforce Centers RWJF Initiative on the Future of Nursing Midwest States Best Practices Forum July 7, 2011

14. What we know now • The National Sample Nursing Study, done every 4 years, probably will not be repeated • The National Healthcare Workforce Data Center is funded • The national Forum of Nursing Workforce Centers developed, vetted and gained endorsement for nursing minimum datasets

15. What else do we know about nursing workforce data today? • It’s inconsistent across the states in content, frequency, analytic approach and reporting • States have the most accurate and current data on their respective nursing workforce IF they are collecting, analyzing and reporting • We have no ability to compare or contrast across states, to aggregate data for groups or regions of states, or to make accurate projections relative to new roles

16. So what? • Legislators and other key decision makers do not have accurate, reliable, valid, current data on which to base resource allocation decisions impacting the nursing workforce • Nurses are accountable to lead the work related to our nursing workforce • Nursing is vulnerable to decisions that are not in the best interest of students, practicing nurses, educators or patients

17. Supply-what we could know with a National MDS • Accurate profiles of nurses by work location, roles, demographics, level of educational preparation, compensation, benefits. • Satisfaction with career, needs/wants for support, education • The experience of newly-graduated RN’s • Approaches that are successful in recruitment and retention • Best practices in nursing care delivery

18. Demand-what we could know with a National MDS • Knowledge, skills, abilities (KSA) required of nurses in new roles and changing current roles in all settings • Best practices in addressing KSA for the incumbent nursing workforce • Numbers needed as delivery models change • Locations where nurses are needed • With healthcare reform, what opportunities are identified for nurses to improve care and access and reduce costs

19. Education-what we could know with a National MDS • Best practices in educational redesign • Successes in enriching the diversity of nursing student and nursing faculty populations • Successes in recruiting and retaining faculty in all settings • Best practices in trans-disciplinary education • What students’ think of their education and what they’d advise us

20. The Nursing Minimum Data Sets • Supply-how many nurses are available to the workforce, at what levels of preparation? • Demand-how many nurses are needed in the workforce as we look to the future? • Education-how many nurses are being educated and at what levels of preparation? • www.nursingworkforccenters.org, Minimum Data Sets • OR, your own state nursing workforce center

21. Questions

22. Aligning Education and Practice Donna L Boland PhD., RN, ANEF Associate Professor and Associate Dean for Evaluation Co-Chair Indiana Action Coalition

23. Midwest Region Webinar • Preparing the future Indiana Nursing Workforce • Interviewed 29 chief nursing administrative officers • Convenient sample but represent all aspects of the state • Majority of respondents represented acute care settings • Minority of respondents had primary responsibility for outpatient settings • Study Purpose • Impact of health care reform on health care • Identification of nursing roles based on perceived reform impact • Identification of competencies nurses will need to meet role revisions • Potential partnerships that will prepare novice nurses to assume role

24. Major FindingsImplications for Education • Paradigm Shift from Sickness to Health • Need for different educational orientation that focuses on health • Different knowledge related to prevention, families, holistic approaches to health, health coaching, understanding behaviors-what motivates actions • Communication skills, motivational interviewing, stress and coping, group and family dynamics • Significant shift in employment settings from in-hospital to out of hospital settings • Being able to understand and manage the gap among care settings • Less emphasis on educating for “sick care” in illness focused settings • Decrease emphasis on tasks and increase emphasis on managing care needs (“managed care on steroids”)

25. Major Implications for Education • Increasing Care Complexity • Complexity in Acute Care Settings • More technology driving need for increasing skills (“technology smart”) • Increasing responsibility for “nurse sensitive outcomes” or non-reimbursable outcomes • Increasing skills in care coordination, delegation, coordinating interprofessional teams • Practice in a rich evidence-based setting • Emphasis on pathophysiology, pathogenesis, genetics, complex assessment skills • “learn thinking” = maximum use of time and effort • Prioritization of work

26. Major Implications for Education • Complexity in Non Acute Settings • Ability to work in more autonomous settings • Care management skills especially across care settings • Communication—communication—communication skills • Managing chronic health issues in an accountable care environment • Focus on prevention, end of life care, health assessment/monitoring skills, promoting self-efficacy skills, health literacy, ethics, economics • Better able to access and coordinate community resources including health, economics, social services, political systems • Development of a “service mentality” (being service oriented) • Increase education skills—focus on promoting and sustaining behavioral change across a continuum of care settings

27. Implications for Changes in Role Preparation of BSN Prepared Nurses • Care Coordinator • Care Coach/Nurse Navigator • Interprofessional /Multidisciplinary Team Leader • Care Manager • SKILLS/COMPETENCIES • System thinker (looking at the big picture-more holistic) • Controller of the environment to promote “healing” • Responsible for patient satisfaction and care outcomes/paid for performance • Succession planning • Understanding the impact of health care reform on care • Nursing visibility • Practice to full extent of education and license • Safety and quality improvement as a way of life

28. Implications for Tomorrow’s Education System • Registered nurses need to be baccalaureate prepared • Challenge in rural areas but needing to build bridges to transition to this educational level of preparation---concern for rigor • LPN role very limited in acute care—more in long term care • Nurses need to be better prepared to assume evolving roles • Partnerships between education and practice to assume responsibility for transition to practice (residency) opportunities that are not specific to institution or educational program

29. Implications for Tomorrow’s Education System • Drivers for New Models for Education and Practice • Focus more on systems thinking—critical thinking as it relates to “understanding inter-relationships”, priorities, “holistic health care” across a continuum of care setting and providers, management of systems • Focus on the idea of interdisciplinary practice and the role of nurses within interprofessional health care teams/breaking down “silos” • Need to prepare nurses for roles and positions outside acute care settings—community, tela-health medicine, involving technology roles, • Increase skills in prevention, health maintenance and end-of-life care • Increase use of simulations as systems having difficulty supporting educational requests/needs • Consumerism mentality • Increasing acuity in acute care settings

30. Policy strategies to support 80% BSN:Michigan’s Story Teresa Wehrwein PhD, RN, NEA-BC Associate Dean for Academic and Clinical Affairs July 7, 2011

31. Overview • State government led strategies • Healthcare system action • Academic policy discussions

32. State Taskforces • Developed to take action on issues raised in the 2005 Nursing Agenda • Commissioned by the Director of the Department of Community Health • Led by Chief Nurse Jeanette Klemczak

33. State Taskforces • Taskforce on Regulation - 2008 • Taskforce on Education – 2009 • To require national accreditation for all pre-licensure programs • To increase safety and quality preparation in programs • To implement residency programs

34. State Taskforces • Taskforce on Practice -in progress • Vision –Michigan’s nurses provide the public with safe high-quality care by practicing to the full extent of their education and competencies • Process - Develop White Papers to support recommendations achieved by consensus • Current activities – Conducting public forums across the state to elicit feedback and working in teams on identified issues

35. Legislation in process • House Bill 4496 • Authorizes Community Colleges to award some baccalaureate degrees including BSN • Pros and cons for enacting the legislation http://www.legislature.mi.gov/(S(yfkgwz45miwzlffy1stcgu55))/mileg.aspx?page=getObject&objectName=2011-HB-4496

36. Health system policy initiatives • Earning the BSN in 10 • Initial discussions at joint taskforce of the statewide leadership groups (3M) • Michigan Organization of Nurse Executives Position Paper • Munson Health System – implementation example

37. Academic policy initiatives • Seamless transition – moving toward joint enrollment • Positioning students to begin University studies while in ADN program • Transfer student status • Financial aid implications

38. Expanding Faculty Capacity in Nursing: Non-traditional Nurse Educators as Online Teachers Susan Taft, PhD, MSN, RN Kent State University College of Nursing Contact: staft@kent.edu; 216-595-9011

39. Part of the National Partners Investing in Nursing* Program Funding provided by 4 foundations:•Robert Wood Johnson Foundation (lead)•Northwest Health Foundation (national)•Cleveland Foundation (local)•Mt. Sinai Health Care Foundation (local) (MSHCF funded Phase 1 to develop curriculum)Project runs Sept. 1, 2010-Aug. 31, 2012*Partners Investing in Nursing’s Future (PIN) is a partnership of the Northwest Health Foundation and the Robert Wood Johnson Foundation to support the capacity, involvement and leadership of local foundations to advance the nursing profession in their own communities.

40. MissionIncrease Nursing Educational Capacity Access a new and previously unrecognized source of nursing faculty, NTNEs*, to supplement and expand educational capacity in U.S. colleges of nursing, and To prepare the NTNEs to deliver high-quality online education part-time to collegiate nursing students. *NTNEs: non-traditional nurse educators

41. Non-traditional Nurse Educators Defined as masters-prepared* nurses working outside of academe who would like to teach part-time; includes nurses working in clinical roles, retired or approaching retirement, engaged in family responsibilities, and/or physically disabled. *Masters degree may be in any discipline

42. NTNEs are being recruited and trained by TNEs – traditional nurse educators – current partners are 1 national and 4 NE Ohio Colleges of Nursing:-Kent State University -Cleveland State University -Ursuline College -University of Akron -St. Joseph’s College of Maine To be cascaded across the U.S. Seeking partners!

43. Project stages

44. Project Stages Phase 1: Pilot Course, Methods of Online Education June-July 2009 Phase 2: Curriculum Development 3-credit hour graduate course developed Phase 3: Train the Trainers, Spring 2011, Methods of Online Education course delivered to 12 participating TNEs from 5 schools of nursing; certified by Quality Matters

45. Project stages – cont. • Phase 4: Developing NTNEs, Spring 2012 • TNEs recruiting masters-level NTNEs & TNEs for course. First graduates: May 2012. Continue in cycles in future. Strong response and interest from NTNEs, many available. • Phase 5: Establish database of NTNEs, beginning fall 2012 and ongoing. Database is a resource for universities to select part-time faculty for online courses.

46. Seeking University Partners for … • Participating TNEs to teach their own Methods course at • their universities • Referral of local, state, or national NTNEsto learn online education • 3. Hiring of NTNE graduates to teach online courses

47. Questions

48. Next Steps • Webinar and materials: www.championnursing.org/events • A resource under development. Will highlight both the national and state perspectives on getting to 80% by 2020 • Learning Collaboratives to convene state and national leaders to continue to share best practices around education.