Nurse Practitioners in Idaho and the Nation: An Update

1. Nurse Practitioners in Idaho and the Nation: An Update

2. What I’ll Address • Idaho Statute: Licensure and Scope of Practice • Supply and Demand for APPN’s and NP’s in Idaho • NP education in Idaho • Current Issues

3. Idaho Statute • History: 1972, 1998, 2004 • Licensed as a “Advanced Practice Professional Nurse” • “..a professional nurse who has gained additional specialized knowledge, skills and experience through a nationally accredited program of study…and is authorized to …practice which may include prescribing, administering and dispensing…pharmacologic agents.” • “APPN shall perform only those acts ..for which the individual is educationally prepared”

4. Includes CNM, NP, CRNA, and CNS • Definition of each type of APPN includes a description of their scope of practice, and the requirements for national certification and for collaboration with other health professionals. • CRNA’s must collaborate with a physician , podiatrist, or dentist.

5. Supply and demand for APPN’s and NP’s in Idaho

6. Source: Idaho Board of Nursing licensure database, 2010.

7. * Totals may not add due to rounding. Source: Idaho Department of Labor 2008-2018 Projections, Idaho Board of Nursing licensure databases and Idaho Department of Labor Job Vacancy Survey, Spring 2010.

8. * Totals may not add due to rounding. Source: Idaho Department of Labor 2008-2018 Projections, Idaho Board of Nursing licensure databases and Idaho Department of Labor Job Vacancy Survey, Spring 2010.

9. Source: Idaho Department of Labor 2008-2018 Projections and Idaho Board of Nursing licensure databases.

10. * Snapshot charts include new supply and demand for each year and the accumulated chronic vacancies.

11. * Snapshot charts include new supply and demand for each year and the accumulated chronic vacancies.

12. Demand and ACA Implementation • Health workforce experts believe that the contributions of NP’s and PA’s are vital if we are to meet the future demand for healthcare. • National shortage of generalists is projected to be 46,000 by 2025 • ACA aims to increase primary care workforce through scholarships, loan repayment and expanded training.

13. But… • There are insufficient numbers of qualified faculty • Clinical training site shortages • Increased insurance coverage and the aging population and increased consumption of services may further exacerbate the shortage

14. NP Education in Idaho • ISU offers a MSN with an FNP option, rural health issues are emphasized • Program is delivered via distance education • Certification exam passage rate approaches 100% • Nationally accredited program through Commission on Collegiate Nursing Education

15. Source: Idaho Board of Nursing Annual Report, September 2010.

16. * As of fall, 2010 College of Western Idaho is no longer admitting LPN students and plans to discontinue the program after current students complete. Source: Idaho Board of Nursing Annual Report, September 2010.

17. Future Plans • ISU is currently developing a DNP curriculum which will be presented to Board of Ed in the Fall • First DNP class admitted tentatively 2013 • BSU is planning DNP in Executive Leadership (planning is still at University level)

18. Current Issues:DNP • Doctoral programs in nursing fall into 2 types: research focused and practice focused • In 2004 the American Association of Colleges of Nursing(AACN) released its position statement on advanced practice education • Nurses practicing at the high level of advanced practice nurses should receive doctoral level preparation

19. Multiple Factors Contributed to this Decision: • Expansion of scientific knowledge required for safe nursing practice • Growing concerns about the quality of patient care and outcomes • Practice demands associated with a complex health system created a mandate for reassessing education for clinical practice for ALL health professions • Extended length of MSN programs

20. Recommended DNP be terminal degree for APRN’s by 2015 • The Commission on Collegiate Nursing Education (CCNE) subsequently announced that only doctoral programs with DNP degree will be considered for CCNE accreditation • Licensure requires graduation from an accredited school, certification eligibility does as well

21. Current Issues:Consensus Model for Licensure • The National Council of State Boards of Nursing (NCSBN) has been working for several years on uniform standards for APRN licensure, accreditation, certification and education standards. • Goal is to have all states adopt the consensus model by 2015

22. Idaho currently substantially complies with the statutory components of the consensus model

23. Current Issues:IOM Report on the Future of Nursing • Released in October 2010 after 2 years of research www.thefutureofnursing.com • 4 key messages • 8 recommendations • Recommendations are actionable at national and state level • States mobilize through regional action coalitions supported by the national Campaign for Action

24. IOM Recommendations Pertinent to NP’s • Message: “Nurses should practice to the full extent of their education and training” • Recommendation#1: Remove Scope of Practice barriers • Message: “Nurses should achieve higher levels of education and training through an improved educational system…” • Recommendation#5: Double the numbers of nurses with a doctorate by 2020