P A U L E T T E C . C O M P T O N , R N , M S N , M C
P R O G R A M D I R E C T O R
B A N N E R B O S W E L L M C C
H E A ...
How is „nursing practice‟
connected to „health care reform‟?
“Many unknowns about health care remain as the
country pushes...
Inter-Dependent Influences
Health Care
&
Health Care
Reform
Nursing
Education
Nursing
Practice
Health Care =
Reality of cu...
Where is the history & evidence US Health Care needs reform?
Jeopardy Answer….‟What is‟ the IOM?
“The Institute of Medicin...
What does the IOM do?
“The IOM applies a distinct research process to
provide objective and straightforward answers to
dif...
What is the IOM?
 Institute of Medicine
 Private, non-governmental, nonprofit organization
providing unbiased and author...
What is the relationship between education & practice?
Past-Present-Future
Nursing
Practice
Nursing
Education
7
3.1.2013Pa...
Nursing Practice-Nursing Education
Relationship
 PAST (History):
Very close relationship with diploma programs in
hospita...
Why are IOM Reports Essential to Nursing
Education?
 The IOM Reports:
1) provide evidence how to improve our healthcare
s...
What is the evidence to support need to improve
nursing education & nursing practice?
 1999 IOM To Err is Human
 IOM Qua...
2010 IOM Future of Nursing Report
Recommendations:
Leading Change, Advancing Health Report
1) Nurses should practice to th...
3.1.2013Paulette C Compton, RN, MSN, MC
12
Relationship/Structure of AZ
Education-Practice Collaborative Task Force
Future of Nursing, Campaign for Action
Funded by ...
IOM & Nursing Education
 “The IOM reports are at the center of the current
restructuring of healthcare systems and the mo...
1999 IOM Report: To Err is Human
 The report identified remarkably high incidence of errors in
health care. At least 44,0...
2001 IOM Report: Crossing the Quality Chasm 2001
 The report found our
health care system is
fragmented, inefficient, an
...
2003 IOM Report: Patient Safety:
Achieving a New Standard of Care
 The report identified the need for a much broader appr...
Note: * Estimate. Expenditures shown in $US PPP (purchasing power parity).
Source: Calculated by The Commonwealth Fund bas...
IOM 2003 Report on 5 Essential Core Competencies
for all Health Professionals Education
19
3.1.2013Paulette C Compton, RN,...
2003 IOM Health Professions Education Report
5 Core Competencies
Patient
Centered
Care
Teamwork &
Collaboration
Evidence-
...
QSEN : Quality and Safety in Nursing Education
(2004) 6 Core Competencies
Patient
Centered
Care
Teamwork &
Collaboration
E...
What is QSEN?
 Quality and Safety Education in Nursing
 QSEN is a comprehensive website for quality and safety
education...
QSEN: Quality & Safety Education in Nursing
 QSEN initial goal to describe competencies which would apply to
ALL nurses &...
Massachusetts Nurse of the Future
10 Core Competency Model
Patient
Centered Care
IOM-QSEN
Teamwork &
Collaboration
IOM-QSE...
25 3.1.2013Paulette C Compton, RN, MSN, MC
Ten Core Nursing Competencies
In 2010 publication
 Nursing Knowledge as foundation
 Communication
 Quality improvement
...
Relationship/Structure of AZ
Education-Practice Collaborative Task Force
Future of Nursing, Campaign for Action
Funded by ...
Survey Monkey Results: #3
28
3.1.2013Paulette C Compton, RN, MSN, MC
Survey Monkey Results: #5
29
3.1.2013Paulette C Compton, RN, MSN, MC
What is the major impact of health care reform
on nursing education?
1) Evidence indicates the need for more educated
nurs...
Nurses are the „least educated‟ healthcare profession!
Healthcare Occupations:
Minimum Education Degree for Entry to Pract...
What is the Tri-Council for Nursing?
“The Tri-Council for Nursing is an alliance of four
autonomous nursing organizations ...
2010 Policy Statement from Tri-Council
for Nursing
Educational Advancement of Registered Nurses:
A Consensus Position (con...
„New‟ Arizona Tri-Council for Nursing
34
 Robin Schaefer, Executive Director, AZNA:
Arizona is in the process of forming ...
What is the major impact of health care reform
on nursing education?
2) Evidence indicates health care reform needs to foc...
What is the major impact of health care reform
on nursing education?
2) Evidence indicates health care reform needs to
foc...
AZ EPC Task Force Model & Purpose
On January 28, 2013 the AZ EPC Task Force
affirmed and adopted the Massachusetts Nurse o...
AZ EPC Task Force Purpose
Consistent with AZ Issues/Concerns
1. Seamless progression through all levels of nursing
educati...
Arizona Nurse of Future
Core Competency Model
1) DECISIONS: AZ (EPCTF) Education-Practice
Collaborative Task Force adopted...
Arizona Assumptions
(Adopted from Massachusetts Assumptions, 2.22.13)
1) Education and Practice partnerships are key to
de...
Arizona Assumptions
(Adopted from Massachusetts Assumptions, 2.22.13)
2) It is imperative that leaders in nursing educatio...
Arizona Assumptions
(Adopted from Massachusetts Assumptions, 2.22.13)
3) There is a need to develop a more effective
educa...
Arizona Assumptions
(Adopted from Massachusetts Assumptions, 2.22.13)
4) The nurse of the future will be proficient at a c...
Additional Arizona Assumption
Approved
6) As nurses and patient advocates, the AZ EPC
Task Force supports the need for inc...
AZ Nurse of the Future: Core Nursing Competencies
These competencies are the expectations for all
professional nurses of ...
What were the professional standards used for the framework
of Nurse of the Future Core Competencies
 ACGME
 AHRQ
 AACN...
Knowledge Attitudes/behaviors Skills
Describes the
nursing context for
improving care
Recognizes that quality
improvement ...
Core Competency Comparisons
Source: Maureen Sroczynski
IOM ACGME QSEN NOF
Apply Quality
Improvement
Practice based
Learnin...
NOF
 Professionalism
 Evidence-based practice
 Nursing knowledge
 Informatics
AACN. (2008). Essentials of
Baccalaureat...
What is the major impact of health care reform
on nursing education?
3) Evidence indicates health care reform needs to foc...
What is the major impact of health care reform
on nursing education?
4) Evidence indicates health care reform needs to
foc...
What is the major impact of health care reform
on nursing education?
5) Evidence indicates health care reform needs to foc...
Evidence New Grad Knowledge Gaps in Quality
Improvement Education
Kovner, C.T., et al. (2010) New Nurses‟ Views of Quality...
What is the major impact of health care reform
on nursing education?
6) Evidence indicates health care reform needs to
foc...
Evidence New Grad Knowledge Gaps in EBP &
Quality Improvement Education
Sullivan, D. T., et al. (2009). Assessing quality ...
What is the major impact of health care reform
on nursing education?
7) Evidence indicates health care reform needs to foc...
What is the major impact of health care reform on
nursing education?
8) Evidence indicates health care reform needs to
foc...
What is the major impact of health care reform on
nursing education?
IMPACT ON NURSING EDUCATION:
Need to educate nurses o...
What is the major impact of health care reform on
nursing education?
IMPACT ON NURSING EDUCATION:
5) Children with special...
What is the major impact of health care reform on
nursing education?
IMPACT ON NURSING EDUCATION:
13) Medical management: ...
What is the major impact of health care reform on
nursing education?
9) Need for nurse clinicians who are also experts in ...
What is the major impact of health care reform on
nursing education?
10) Need for nurse clinicians who are also experts in...
SUMMARY: 10 Selected Major Impacts of Health
Care Reform on Nursing Education
63
 10 selected impacts identified; not com...
DropBox
64
 DropBox „link‟ to access AZ Education-Practice
Collaborative Task Force docs:
https://www.dropbox.com/sh/79qv...
Questions/Comments
3.1.2013Paulette C Compton, RN, MSN, MC
65
Upcoming SlideShare
Loading in …5
×

Healing community pp, 3.1.13

827 views

Published on

0 Comments
1 Like
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total views
827
On SlideShare
0
From Embeds
0
Number of Embeds
1
Actions
Shares
0
Downloads
23
Comments
0
Likes
1
Embeds 0
No embeds

No notes for slide

Healing community pp, 3.1.13

  1. 1. P A U L E T T E C . C O M P T O N , R N , M S N , M C P R O G R A M D I R E C T O R B A N N E R B O S W E L L M C C H E A L I N G C O M M U N I T Y A N N U A L S P R I N G M E E T I N G M A R C H 1 , 2 0 1 3 2010 IOM Future of Nursing Report & Health Care Reform: Impact on Nursing Practice & Nursing Education
  2. 2. How is „nursing practice‟ connected to „health care reform‟? “Many unknowns about health care remain as the country pushes forward with health care reform. But one thing is certain. The US cannot adequately address the challenges facing its health care system without addressing the challenges facing the nursing profession. Nurses are the largest segment of the heath care workforce and are essential to providing quality care…….The goal of this initiative is to help transform nursing as part of far-reaching reforms in the health care system.”  SOURCE: Preface to Summary of IOM October 2009 Forum on the Future of Nursing: Acute Care 2 3.1.2013Paulette C Compton, RN, MSN, MC
  3. 3. Inter-Dependent Influences Health Care & Health Care Reform Nursing Education Nursing Practice Health Care = Reality of current health care now and future Health Care Reform** = Needed changes in health care now and future 3 3.1.2013Paulette C Compton, RN, MSN, MC **ANA website link: http://www.n ursingworld.or g
  4. 4. Where is the history & evidence US Health Care needs reform? Jeopardy Answer….‟What is‟ the IOM? “The Institute of Medicine asks and answers the nation‟s most pressing questions about health and health care.” “The mission of the IOM is to advise the nation on matters of health and medicine.” SOURCE: www.iom.edu/About-IOM.aspx 4 3.1.2013Paulette C Compton, RN, MSN, MC
  5. 5. What does the IOM do? “The IOM applies a distinct research process to provide objective and straightforward answers to difficult questions of national importance.” “These leading national and international scientists [who conduct the studies], all of whom serve as volunteers, are asked to set aside preconceptions and to rely on evidence in their pursuit of knowledge and truth.” SOURCE: www.iom.edu/About-IOM.aspx 5 3.1.2013Paulette C Compton, RN, MSN, MC
  6. 6. What is the IOM?  Institute of Medicine  Private, non-governmental, nonprofit organization providing unbiased and authoritative advice to decision makers and the public.  Established in 1970, the IOM is the health arm of the National Academy of Sciences, chartered under President Abraham Lincoln in 1863.  www.iom.edu SOURCE: www.iom.edu/About-IOM.aspx 6 3.1.2013Paulette C Compton, RN, MSN, MC
  7. 7. What is the relationship between education & practice? Past-Present-Future Nursing Practice Nursing Education 7 3.1.2013Paulette C Compton, RN, MSN, MC
  8. 8. Nursing Practice-Nursing Education Relationship  PAST (History): Very close relationship with diploma programs in hospitals  PRESENT: Disconnected; education silo & practice silo  NOW & FUTURE: Need to collaborate on preparing nurse of future AZ Action Coalition Education-Practice Collaborative Task Force 8 3.1.2013Paulette C Compton, RN, MSN, MC
  9. 9. Why are IOM Reports Essential to Nursing Education?  The IOM Reports: 1) provide evidence how to improve our healthcare system 2) provide evidence how to improve the health of Americans & improve patient outcomes in our nursing practice 3) IOM focus is also on healthcare professions education with goal of a consistent framework with all healthcare professions education emphasizing interdisciplinary care SOURCE: Finkelman A & Kenner, C (2009) Teaching IOM: Implications of the IOM Reports for Nursing Education. ANA: Silver Spring, MD 9 3.1.2013Paulette C Compton, RN, MSN, MC
  10. 10. What is the evidence to support need to improve nursing education & nursing practice?  1999 IOM To Err is Human  IOM Quality Chasm series  2003 IOM Health Professions Education  2004 QSEN  2009 Patricia Benner‟s book, Educating Nurses: A Call for Radical Transformation  2010 IOM Nurse of the Future, Leading Change, Advancing Health 10 3.1.2013Paulette C Compton, RN, MSN, MC
  11. 11. 2010 IOM Future of Nursing Report Recommendations: Leading Change, Advancing Health Report 1) Nurses should practice to the full extent of their education and training. 2) Nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression. 2) Nurses should be full partners, with physicians and other health care professionals, in redesigning health care in the United States. 2) Effective workforce planning and policy making require better data collection and an improved information infrastructure.
  12. 12. 3.1.2013Paulette C Compton, RN, MSN, MC 12
  13. 13. Relationship/Structure of AZ Education-Practice Collaborative Task Force Future of Nursing, Campaign for Action Funded by AARP & RWJF www.campaignforaction.org AZ Action Coalition (AC) www.futureofnursingaz.com AZ AC Education Task Force is a sub-committee of AZ Action Coalition (AC) AZ Education-Practice Collaborative Task Force is the responsibility of AZ AC Education Task Force 13 3.1.2013Paulette C Compton, RN, MSN, MC
  14. 14. IOM & Nursing Education  “The IOM reports are at the center of the current restructuring of healthcare systems and the movement toward inter-professional work, and they influence funding from research, education, and health policy agencies and professional organizations. They ( IOM reports) should therefore be at the core of all nursing education programs.” Finkelman& Kenner, (2009) Teaching IOM, P.xvii.  “Educators often feel they know what needs to be taught though they have long been out of practice or only practice intermittently. This is a dangerous stand to take and may have poorly served students or employers who hire new graduates. This is also not serving our consumers, patients and their families.” Finkelman& Kenner, (2009)Teaching IOM, pp.xviii-xix. 14 3.1.2013Paulette C Compton, RN, MSN, MC
  15. 15. 1999 IOM Report: To Err is Human  The report identified remarkably high incidence of errors in health care. At least 44,000 to 98,000 people die in hospitals each year in the US as a result of medical errors that could have been prevented, based on estimates from two major studies.  Definition of „medical error‟-the failure of a planned action to be completed as intended or the use of a wrong plan to achieve an aim.  The highest incidence of medical errors with serious consequences occurs more frequently in ICUs, ORs, and EDs.  Recommendation of need to change to blame-free environment which does not focus on punishing individuals for errors but changes to a root cause analysis to determine individual practice and system problems which result in errors. 15 3.1.2013Paulette C Compton, RN, MSN, MC
  16. 16. 2001 IOM Report: Crossing the Quality Chasm 2001  The report found our health care system is fragmented, inefficient, an d poorly organized.  IOM 1990 definition of „quality‟-“the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge.”  The report identified „quality‟ as a system property with six important improvement aims. Health care „quality‟ should be:  Safe  Effective  Patient-centered  Timely  Efficient  Equitable 16 3.1.2013Paulette C Compton, RN, MSN, MC
  17. 17. 2003 IOM Report: Patient Safety: Achieving a New Standard of Care  The report identified the need for a much broader approach to patient safety than was first stated in To Err is Human.  Definition of „patient safety‟-The prevention of harm to patients, where harm can occur through errors of commission and omission.  The report describes the need for commitment from all stakeholders to a culture of safety and improved information system, which us clinical data at point of care to prevent, recognize, and recover from adverse events.  Recommended need HHS assume lead role for establishing a standards-based nation health information infrastructure to support comprehensive patient safety programs to detect and analyze adverse events and near misses. 17 3.1.2013Paulette C Compton, RN, MSN, MC
  18. 18. Note: * Estimate. Expenditures shown in $US PPP (purchasing power parity). Source: Calculated by The Commonwealth Fund based on 2007 International Health Policy Survey; 2008 International Health Policy Survey of Sicker Adults; 2009 International Health Policy Survey of Primary Care Physicians; Commonwealth Fund Commission on a High Performance Health System National Scorecard; and Organization for Economic Cooperation and Development, OECD Health Data, 2009 (Paris: OECD, Nov. 2009). AUS CAN GER NETH NZ UK US OVERALL RANKING (2010) 3 6 4 1 5 2 7 Quality Care 4 7 5 2 1 3 6 Effective Care 2 7 6 3 5 1 4 Safe Care 6 5 3 1 4 2 7 Coordinated Care 4 5 7 2 1 3 6 Patient-Centered Care 2 5 3 6 1 7 4 Access 6.5 5 3 1 4 2 6.5 Cost-Related Problem 6 3.5 3.5 2 5 1 7 Timeliness of Care 6 7 2 1 3 4 5 Efficiency 2 6 5 3 4 1 7 Equity 4 5 3 1 6 2 7 Long, Healthy, Productive Lives 1 2 3 4 5 6 7 Health Expenditures/Capita, 2007 $3,357 $3,895 $3,588 $3,837* $2,454 $2,992 $7,290 Country Rankings 1.00–2.33 2.34–4.66 4.67–7.00 Overall Ranking 18 3.1.2013Paulette C Compton, RN, MSN, MC
  19. 19. IOM 2003 Report on 5 Essential Core Competencies for all Health Professionals Education 19 3.1.2013Paulette C Compton, RN, MSN, MC
  20. 20. 2003 IOM Health Professions Education Report 5 Core Competencies Patient Centered Care Teamwork & Collaboration Evidence- based Practice Informatics Quality Improvement 20 3.1.2013Paulette C Compton, RN, MSN, MC
  21. 21. QSEN : Quality and Safety in Nursing Education (2004) 6 Core Competencies Patient Centered Care Teamwork & Collaboration Evidence- based Practice Informatics Quality Improvement Safety QSEN 21 3.1.2013Paulette C Compton, RN, MSN, MC
  22. 22. What is QSEN?  Quality and Safety Education in Nursing  QSEN is a comprehensive website for quality and safety education for nurses, funded by Robert Wood Johnson Foundation  QSEN is a faculty resource to learn and share ideas about teaching-learning strategies, which promote quality and safety competency development in nursing  QSEN includes video presentations and annotated bibliographies for faculty and nursing students to learn about quality and safety in nursing  www.QSEN.org SOURCE: www.QSEN.org 22 3.1.2013Paulette C Compton, RN, MSN, MC
  23. 23. QSEN: Quality & Safety Education in Nursing  QSEN initial goal to describe competencies which would apply to ALL nurses & define a competent and qualified nurse.  QSEN utilized IOM recommended 5 competencies for all health professions AND created 2 competencies for IOM Quality Improvement competency: Quality Improvement & Safety  QSEN identified KSAs (Knowledge, Skills, & Attitudes) for each competency  QSEN competencies to serve as guide for  Curricular development for academic programs  Transition to practice  Continuing education programs. 23 3.1.2013Paulette C Compton, RN, MSN, MC
  24. 24. Massachusetts Nurse of the Future 10 Core Competency Model Patient Centered Care IOM-QSEN Teamwork & Collaboration IOM-QSEN Evidence-based Practice IOM-QSEN Informatics IOM-QSEN Quality Improvement IOM-QSEN Safety QSEN Leadership Mass NOF Communication Mass NOF Professionalism Mass NOF Systems-based Practice Mass NOF Source: http://www.mass.edu/currentinit/Ni NofCompetencies.asp 3.1.2013Paulette C Compton, RN, MSN, MC
  25. 25. 25 3.1.2013Paulette C Compton, RN, MSN, MC
  26. 26. Ten Core Nursing Competencies In 2010 publication  Nursing Knowledge as foundation  Communication  Quality improvement  Safety  Evidence-based practice  Patient centered care  Leadership  Teamwork and Collaboration  Professionalism  Informatics  Systems Based Practice 26 3.1.2013Paulette C Compton, RN, MSN, MC
  27. 27. Relationship/Structure of AZ Education-Practice Collaborative Task Force Future of Nursing, Campaign for Action Funded by AARP & RWJF www.campaignforaction.org AZ Action Coalition (AC) www.futureofnursingaz.com AZ AC Education Task Force is a sub-committee of AZ Action Coalition (AC) AZ Education-Practice Collaborative Task Force is the responsibility of AZ AC Education Task Force 27 3.1.2013Paulette C Compton, RN, MSN, MC
  28. 28. Survey Monkey Results: #3 28 3.1.2013Paulette C Compton, RN, MSN, MC
  29. 29. Survey Monkey Results: #5 29 3.1.2013Paulette C Compton, RN, MSN, MC
  30. 30. What is the major impact of health care reform on nursing education? 1) Evidence indicates the need for more educated nurses due to the increasingly complex health care system and improved patient outcomes, including decreased mortality and decrease failure to rescue, with increased percentages of BSN RNs. IMPACT ON NURSING EDUCATION: 1) Increase pre-licensure BSN pipeline 2) Increase seamless educational progression programs from ADN RN to BSN and/or MSN RN 3) Increase concurrent enrollment pipeline of ADN/BSN programs 30 3.1.2013Paulette C Compton, RN, MSN, MC
  31. 31. Nurses are the „least educated‟ healthcare profession! Healthcare Occupations: Minimum Education Degree for Entry to Practice  Associate  Registered Nurse  Respiratory Therapist Tech  Pharmacy Tech  Occupational Therapy Assistants  Physical Therapy Assistants  Baccalaureate  Respiratory Therapist  Masters  Occupational Therapist  Social Worker  Speech Therapist  Counselor  Doctoral  Physician  Pharmacist  Physical Therapist 31 3.1.2013Paulette C Compton, RN, MSN, MC
  32. 32. What is the Tri-Council for Nursing? “The Tri-Council for Nursing is an alliance of four autonomous nursing organizations each focused on leadership for education, practice and research. …... These organizations represent nurses in practice, nurse executives and nursing educators….” Tri-Council Member Organizations: 1) American Nurses Association 2) National League for Nursing 3) American Association of Colleges of Nursing 4) American Organization of Nurse Executives 32 3.1.2013Paulette C Compton, RN, MSN, MC
  33. 33. 2010 Policy Statement from Tri-Council for Nursing Educational Advancement of Registered Nurses: A Consensus Position (cont) Quote from 2010 Policy Statement: “A more highly educated nursing profession is no longer a preferred future; it is a necessary future in order to meet the nursing needs of the nation and to deliver effective and safe care.” 33 3.1.2013Paulette C Compton, RN, MSN, MC
  34. 34. „New‟ Arizona Tri-Council for Nursing 34  Robin Schaefer, Executive Director, AZNA: Arizona is in the process of forming a tri-council. It will be called Arizona Tri-Council for Nursing, based on the national Tri-Council for Nursing model with 4 organizations. The first meeting was on January 25th. The group is in the process of writing the mission and identifying areas for collaboration. The involved groups are:  Arizona Nurses Association (AzNA)  Arizona Organization of Nurse Executives (AzONE)  Arizona League for Nursing (AzLN)  Arizona State Board of Nursing (AZBN) 3.1.2013Paulette C Compton, RN, MSN, MC
  35. 35. What is the major impact of health care reform on nursing education? 2) Evidence indicates health care reform needs to focus on nurses (and all health professions) educational preparation in all of the 10 Mass. Nurse of the Future Core Competencies. IMPACT ON NURSING EDUCATION: 1) Need to educate nurses all of the 10 Mass NOF core competencies 2) Need to incorporate all Mass NOF core competencies knowledge, skills, and attitudes content in all levels of nursing education, including RN-to-BSN 3) Proposed rule change in AZ Nurse Practice Act will require all nursing programs to include the 6 IOM/QSEN core competencies in the curriculum. 35 3.1.2013Paulette C Compton, RN, MSN, MC
  36. 36. What is the major impact of health care reform on nursing education? 2) Evidence indicates health care reform needs to focus on nurses (and all health professions) educational preparation in all of the 10 Mass. Nurse of the Future Core Competencies. (continued) IMPACT ON NURSING EDUCATION: 4) AZ Education-Practice Collaborative Task Force (AZEPCTF) officially affirmed the adoption of the Mass Nurse of Future Core Competency Model and changed the name. 36 3.1.2013Paulette C Compton, RN, MSN, MC
  37. 37. AZ EPC Task Force Model & Purpose On January 28, 2013 the AZ EPC Task Force affirmed and adopted the Massachusetts Nurse of the Future Core Competency Model and Purpose:  Establish a formal coalition (AZ AC Education- Practice Collaborative Task Force: AZ EPCTF) to create a seamless progression through all levels of nursing that is based on the evidence-based consensus competencies of the Massachusetts Nurse of the Future Core Competency Model, which includes transitioning nurses into their practice settings. 37 AZ EPCTF Meeting, Feb 22, 2013
  38. 38. AZ EPC Task Force Purpose Consistent with AZ Issues/Concerns 1. Seamless progression through all levels of nursing education (AZ- New Grad Practice Readiness) 2. Consensus on competencies to serve as a framework for educational curriculum (AZ acceptance of AZ Evidence-Based Massachusetts Nurse of the Future Core Competency Model) 3. Nurse internship/preceptor program (AZ-New Grad Practice Readiness & Nurse Residency) 38 AZ EPCTF Meeting, Feb 22, 2013
  39. 39. Arizona Nurse of Future Core Competency Model 1) DECISIONS: AZ (EPCTF) Education-Practice Collaborative Task Force adopted the Massachusetts Nurse of Future Core Competency Model on 1.28.13 and changed the name on 2.22.13 2) REVISED NAME: Arizona Nurse of Future Core Competency Model (AZ EPCTF adopted and changed the name of the Massachusetts Nurse of Future Core Competency Model) AZ EPCTF Meeting, Feb 22, 2013
  40. 40. Arizona Assumptions (Adopted from Massachusetts Assumptions, 2.22.13) 1) Education and Practice partnerships are key to developing an effective model. – Nursing education and practice setting should facilitate individuals to move more effectively move through the educational system. – An integrated practice/education competency model will positively impact patient safety and improve patient care. – Nursing practice should be differentiated according to the registered nurse‟s educational preparation and the level of practice and further defined by the role of the nurse and the work setting – Practice environments that support and enhance professional competence are essential. 40 AZ EPCTF Meeting, Feb 22, 2013
  41. 41. Arizona Assumptions (Adopted from Massachusetts Assumptions, 2.22.13) 2) It is imperative that leaders in nursing education and practice develop collaborative curriculum models to facilitate the achievement of a minimum of a baccalaureate degree in nursing (BSN) by all nurses. – Advancing the education of all nurses is increasingly being recognized as essential to the future of nursing practice. – Evidence has demonstrated that nurses with higher education levels have a positive impact on patient care. *Please note this assumption does NOT state „BSN minimal entry into practice‟ but means the goal is for all RNs, including Diploma & Associate RNs, to achieve BSN through collaborative curriculum models. 41 AZ EPCTF Meeting, Feb 22, 2013
  42. 42. Arizona Assumptions (Adopted from Massachusetts Assumptions, 2.22.13) 3) There is a need to develop a more effective educational system that is capable of incorporating the shifting demographics in order to prepare the nursing workforce to respond to current and future health care needs and population health issues. – The competencies are designed to be applicable across all care settings and to encompass all patient populations across the lifespan. – In this global society, essential to the care of diverse populations is the need for evidence-based knowledge and sensitivity to variables such as age, gender, culture, health disparities, socioeconomic status, race, and spirituality. 42 AZ EPCTF Meeting, Feb 22, 2013
  43. 43. Arizona Assumptions (Adopted from Massachusetts Assumptions, 2.22.13) 4) The nurse of the future will be proficient at a core set of competencies. – There is a differentiation in competencies among practicing nurses at various levels. – Competence is developed over a continuum and can be measured 5) Nurse educators in both education and practice settings will need to use a different set of knowledge and teaching strategies to effectively integrate the Nurse of the Future competencies into curriculum. 43 AZ EPCTF Meeting, Feb 22, 2013
  44. 44. Additional Arizona Assumption Approved 6) As nurses and patient advocates, the AZ EPC Task Force supports the need for increased education for all nurses because with increasingly complex health care, the patient requires a more educated nurse in order to deliver effective and safe care. The Massachusetts NOF assumptions and the above additional assumption were adopted by the AZ EPCTF on Feb 22, 2013. 44 AZ EPCTF Meeting, Feb 22, 2013
  45. 45. AZ Nurse of the Future: Core Nursing Competencies These competencies are the expectations for all professional nurses of the future. The Knowledge, Attitude and Skills (KAS) grids are the minimal expectations for initial nursing practice following completion of any pre- licensure professional nursing educational program.
  46. 46. What were the professional standards used for the framework of Nurse of the Future Core Competencies  ACGME  AHRQ  AACN  ANA  AONE  Bologna Accord  CCNE  COPA  IOM  ICN  NCSBN  NLN  NLNAC  QSEN See page 42, NOF Core Competencies
  47. 47. Knowledge Attitudes/behaviors Skills Describes the nursing context for improving care Recognizes that quality improvement is an important part of being a nurse. Actively seeks information about quality improvement from relevant institutional, regulatory and local/national sources. Understands that the nurse and care delivered is part of a broader health care system. Recognizes that interdependent relationships and a professional work process are important to quality improvement. Participates in the use of quality improvement tools (such as flow charts, cause & effect diagrams) to make processes of care interdependent and explicit Explains the importance of variation and measurement in providing quality nursing care. Appreciates how unwanted variation affects care and how standardization can support quality patient care. Participates in the use of quality measures (such as control and run charts) to assess performance and identify gaps between local and best practices. Describes approaches for changing processes of care in which the learner is involved. Recognizes the value of what individuals and teams can do to improve care. Participates in the use of measures to evaluate the effect of changes in the delivery of care. Quality Improvement The Nurse of the Future will use data to monitor outcomes and care processes, and use improvement methods to design and test changes to continuously improve the quality and safety of healthcare.
  48. 48. Core Competency Comparisons Source: Maureen Sroczynski IOM ACGME QSEN NOF Apply Quality Improvement Practice based Learning & Improvement Systems Based Practice Quality Improve- ment Safety Quality Improvement Safety Systems based practice Provide Patient- Centered Care Patient Care Interpersonal & Communication Skills Patient Centered Care Patient Centered Care Communication Leadership Work in Inter- Disciplinary Teams Professionalism Teamwork and Collaboration Teamwork and Collaboration Professionalism Employ Evidenced- Based Practice Medical Knowledge Evidence based practice Evidence based practice Utilize Informatics Informatics Informatics
  49. 49. NOF  Professionalism  Evidence-based practice  Nursing knowledge  Informatics AACN. (2008). Essentials of Baccalaureate Education for Professional Nursing Practice (adopted by AACN 10/28/08)  Professionalism & Professional Values  Scholarship for evidence-based practice  Liberal Education & Discipline of Nursing  Information Literacy & Information Management and Patient Care Technology
  50. 50. What is the major impact of health care reform on nursing education? 3) Evidence indicates health care reform needs to focus on promotion of wellness in the community and decreased hospital admissions. IMPACT ON NURSING EDUCATION: 1) Need to educate nurses on the role of „the nurse coach,‟ which will be a new important role in health care 2) Need to educate nurses on „motivational counseling/interviewing.‟ 3) Need to have increased clinical experiences in „the community with health promotion‟ rather than treatment focus in acute care 50 3.1.2013Paulette C Compton, RN, MSN, MC
  51. 51. What is the major impact of health care reform on nursing education? 4) Evidence indicates health care reform needs to focus on management of multiple chronic illnesses. IMPACT ON NURSING EDUCATION: 1) Need to educate nurses on the role of management of multiple chronic illnesses. 2) Need to educate nurses on „motivational counseling/interviewing.‟ 3) Need to have increased clinical experiences in „the community‟ with focus on management of multiple chronic illnesses 51 3.1.2013Paulette C Compton, RN, MSN, MC
  52. 52. What is the major impact of health care reform on nursing education? 5) Evidence indicates health care reform needs to focus on safety and quality improvement IMPACT ON NURSING EDUCATION: 1) Need to educate nurses about quality improvement processes, including root cause analysis, near misses, system-based practice to prevent avoidable medical errors 2) Evidence indicates new RN grads have not been taught about quality improvement 3) Evidence indicates harm rates continue to be about same level as 1999 IOM To Err is Human data. 4) New role „Nurse patient safety officer‟ 52 3.1.2013Paulette C Compton, RN, MSN, MC
  53. 53. Evidence New Grad Knowledge Gaps in Quality Improvement Education Kovner, C.T., et al. (2010) New Nurses‟ Views of Quality Improvement Education. The Joint Commission Journal on Quality and Patient Safety. 36(1), 29-35. STUDY RESULTS: N=436 (38.6%) newly licensed RNs thought they were “poorly” or “very poorly” prepared about or had “never heard of QI.” BSN grads reported significantly higher levels of preparation in EBP, evidenced-based practice; assessing gaps in practice, teamwork, collaboration; and many research skills. STUDY CONCLUSIONS: RN educational programs need to improve education about and application of QI concepts and to consider focusing QI content into a separate course to assure it is taught. 53 3.1.2013Paulette C Compton, RN, MSN, MC
  54. 54. What is the major impact of health care reform on nursing education? 6) Evidence indicates health care reform needs to focus on evidence-based practice IMPACT ON NURSING EDUCATION: 1) Need to educate nurses about evidence-base practice 2) Need to increase EBP curriculum content in all levels of nursing education 3) Evidence indicates new RN grads have not been adequately taught about evidence-base practice 54 3.1.2013Paulette C Compton, RN, MSN, MC
  55. 55. Evidence New Grad Knowledge Gaps in EBP & Quality Improvement Education Sullivan, D. T., et al. (2009). Assessing quality and safety competencies of graduating prelicensure nursing students. Nursing Outlook. 57, 323-331. STUDY RESULTS: N= 565. Only 49% newly licensed RNs reported curriculum included reliable resources for locating evidence-based reports and clinical guidelines. Students believed they were most prepared to perform skills in core competencies patient-centered care & informatics. Students felt least prepared for skills in evidenced-based practice & quality improvement tools and evaluating the effects of practice changes. STUDY CONCLUSIONS: Due to gaps between theoretical presentation of quality and safety information and demonstrated application in practice, need to focus on redesign of curriculum content to include quality and safety education/practices. Special attention is needed to develop student competency in quality improvement. Paulette C Compton, RN, MSN, MC 55 3.1.2013
  56. 56. What is the major impact of health care reform on nursing education? 7) Evidence indicates health care reform needs to focus on improving health literacy. IMPACT ON NURSING EDUCATION: 1) Need to educate nurses about health literacy 2) Need to increase health literacy curriculum content in all levels of nursing education 3) Evidence indicates new RN grads need health literacy evidence-based practice interventions to improve health literacy and decrease avoidable medical errors resulting from poor health literacy. 56 3.1.2013Paulette C Compton, RN, MSN, MC
  57. 57. What is the major impact of health care reform on nursing education? 8) Evidence indicates health care reform needs to focus on high incidence with high mortality/morbidity management of chronic illnesses. IMPACT ON NURSING EDUCATION: Need to educate nurses on evidence-base treatment for 20 priority areas for curricular content (2003 IOM Report-Priority Areas for National Action: Transforming Health Care) Based on: A) Impact or extent of burden B) Improvability or gap between current practice and evidence-based practice C) Inclusiveness or relevance of an area to broad range of individuals 57 3.1.2013Paulette C Compton, RN, MSN, MC
  58. 58. What is the major impact of health care reform on nursing education? IMPACT ON NURSING EDUCATION: Need to educate nurses on evidence-based treatment for 20 priority areas for curricular content (2003 IOM Report- Priority Areas for National Action: Transforming Health Care) Areas in most need of improvement in nursing curriculums in red font 1) Care coordination 2) Self-Management & health literacy 3) Asthma 4) Cancer screening evidence-based, focus on colorectal and cervical 58 3.1.2013Paulette C Compton, RN, MSN, MC
  59. 59. What is the major impact of health care reform on nursing education? IMPACT ON NURSING EDUCATION: 5) Children with special health care needs 6) Diabetes 7) End of life care with advanced system failure 8) Frailty associated with old age 9) Hypertension 10) Immunizations 11) Ischemic heart disease 12) Major depression screening and treatment 59 3.1.2013Paulette C Compton, RN, MSN, MC
  60. 60. What is the major impact of health care reform on nursing education? IMPACT ON NURSING EDUCATION: 13) Medical management: Preventing medication errors and overuse of antibiotics 14) Nosocomial infections 15) Pain control 16) Pregnancy and childbirth 17) Severe and persistent mental illness 18) Stroke 19) Tobacco dependence 20) Obesity 60 3.1.2013Paulette C Compton, RN, MSN, MC
  61. 61. What is the major impact of health care reform on nursing education? 9) Need for nurse clinicians who are also experts in how to implement technology to improve patient care quality IMPACT ON NURSING EDUCATION: 1) Need to educate nurses to assume roles of A) Chief nursing informatics officer B) Chief nursing clinical informatics officer 2) Advanced practice degree in informatics and certification in clinical informatics 61 3.1.2013Paulette C Compton, RN, MSN, MC
  62. 62. What is the major impact of health care reform on nursing education? 10) Need for nurse clinicians who are also experts in how to coordinate care IMPACT ON NURSING EDUCATION: 1) Need to educate nurses to assume roles of A) Care coordinator B) Nurse Navigator 2) VA „Nurse navigator role‟ uses VA Nurse-Patient Shared Decision Support Tool (Source: Holtz,B. et al (2013) A Nurse-Patient Shared Decision Support Tool. AJN(113)1. 62 3.1.2013Paulette C Compton, RN, MSN, MC
  63. 63. SUMMARY: 10 Selected Major Impacts of Health Care Reform on Nursing Education 63  10 selected impacts identified; not comprehensive Check out ANA resources on Health Care Reform: http://nursingworld.org/MainMenuCategories/Policy- Advocacy/HealthSystemReform  Significant need for advanced practice primary care nurse practitioners not included in presentation  Collaboration between nursing education and nursing practice essential to improve new grad practice readiness to meet the quality and safety needs of patients and families  If you are interested in volunteering to work on AZ Education-Practice Collaborative Task Force, email me: Paulette.Compton@bannerhealth.com 3.1.2013Paulette C Compton, RN, MSN, MC
  64. 64. DropBox 64  DropBox „link‟ to access AZ Education-Practice Collaborative Task Force docs: https://www.dropbox.com/sh/79qvd8u71awjjd4/yebF UkJjlh 3.1.2013Paulette C Compton, RN, MSN, MC
  65. 65. Questions/Comments 3.1.2013Paulette C Compton, RN, MSN, MC 65

×