2. Objective
• The objective of this meeting is to update the Nursing Advisory Committee
on program performance and current healthcare trends.
• Areas of Focus are current trends in healthcare, issues, and trends affecting
nursing education and annual outcomes of completion, graduation, NCLEX-
PN, NCLEX-RN pass rates, and Placement rates.
5. Recommendations
VerifyThe Integrity of the Data
Identify Drivers for low Completion Rate
EvaluateWhat is working in the PN Program andWhat is NotWorking in the RN Program
Institute Progression Program
Review Courses
Study Plans
Remediation
Use StandardizedTesting as aTool
Psychosocial Support.
6. Accreditation andWhy is it Important
Definition.
Why is ACEN Accreditation important?
Disadvantages of No Accreditation.
13. Cultural Competence vs Cultural Humility
Concept of Cultural Competence
Concept of Cultural Humility
14. Summary
• In conclusion, we need to examine and evaluate the current trends and
challenges our nursing program is facing and address how we can ensure
the successful growth of our program.
15. References
• AACN. (2020a). Fact sheet: nursing faculty shortage. aacnursing.org. https://www.aacnursing.org/Portals/42/News/Factsheets/Faculty-Shortage-Factsheet.pdf
• AACN. (2020b, September). Nursing shortage. aacnnursing.org. https://www.aacnnursing.org/News-Information/Fact-Sheets/Nursing-Shortage
• ACEN. (2021, May). Frequently asked questions. acenursing.org. https://www.acenursing.org/faq/
• ANI. (2022). Nursing informatics. amia.org. https://amia.org/communities/nursing-informatics
• Carlson, K. (2021, February 7). Five challenges nurses will face in 2021. nursing.com. https://www.nursingce.com/blog/five-challenges-nurses-will-face-in-2021
• Flaubert J, LeMenestrel S, Williams D. (2021). The future of nursing 2020-2030: charting a path to achieve health equity. National Academies Press (US), Washington (DC).
https://www.ncbi.nlm.nih.gov/books/NBK5739121
• Garcia-Day, M. (2021). Nursing informatics. Nursing Management, 52(5), 5–56. https://journals.lww.com/nursingmanagement/fulltext/2021/05000/nursing_informatics_an_evolution_specialty.10.aspy
• HRSA. (2021). Learn more about telehealth. telehealth.hhs.gov. https://telehealth.hhs.gov
• Jacobson, G. (2021, October 1). When costs are barrier to getting healthcare: reports from older adults in the united states and other high income countries. commonwealthfund.org.
https://www.commonwealthfund.org/publications/surveys/2021/oct/when-costs-are-barriers-getting-health-care-older-adults-survey
• Meola, A. (2020). The aging u.s. population is creating many problems-especially regarding elderly healthcare issues. insiderintelligence.com. https://www.insiderintelligence.com/insights/aging-
population-healthcare
• Milken Institute School of Public Health. (2022). The growing cost of aging in america part 1: an aging population and rising health care costs. onlinepublichealth.gwu.edu.
https://onlinepublichealth.gwu.edu/resources/cost-of-aging-healthcare
• Morelock, S. (2022). Current and future educational challenges for the nurse educator. rn-journal.com. https://rn-journal.com/journal-of-nursing/educational-challenge-in-nurse-education
• NCO. (2022). The top most common chronic conditions in older adults. www.ncoa.org. https://www.ncoa.org/article/the-top-10-most-common-chronic-conditions-in-older-adults
• Spring Arbor University. (2021, May). Top 15 nursing trends to watch in 2022. online.arbor.edu. https://online.arbor.edu/news/nursing/trends
• University of St. Augustine. (2021, May). The 2021 american nursing shortage: a data study. usa.edu. https://www.usa.edu/blog/nursing-shortage
Editor's Notes
We have performed an analysis of current data relative to established goals. Out of 5 key performance indicators, we have exceeded the goal on three of them. Our graduation rate is 83%, and the accreditation requirement is 70%. NCLEX-PN pass rate is 84%, accreditation requirement is 80%, Placement rate is 87%, and accreditation requirement is 70%.
The areas we underperformed were the Completion Rate of 67% against a goal of 70%, and the NCLEX-RN pass Rate is 78% against a goal of 80%.
Verify the integrity of the data. We want to make sure the data we are using is accurate.
Identify Drivers for Low Completion Rate
For example: are students having a financial issue, do we offer financial aid to assist students, scholarship awareness. Access to and availability of courses, personal issues,
Evaluate What is working in the PN Program and What is Not Working in the RN Program
To learn what is driving success in the PN program and explore if that can be translated into the RN program.
RN education is evolving, and the curriculum is evolving, so educators need to be adequately prepared.
A study by Quinn et al. (2018) concluded that using the following framework, students received a first-time pass rate of at least 97%.
Progression program
Review courses with remediation
Standardized testing as a tool
Helped develop critical thinking and become familiar with the NCLEX-RN format, style and content.
The study also showed using psychosocial support such as academic advising, support groups, test that taking skills, and anxiety control, students reported a decrease in anxiety when preparing for the NCLEX-RN exam.
Credential evaluation will become even more important in the future as nurses from different countries continue emigrating to the United States with the expectation that they will be able to practice immediately as registered nurses (Morelock, 2022).
Definition: A voluntary, peer- review, self-regulatory process by which non-governmental associations recognize educational institutions or programs that have been found to meet or exceed standards and criteria for educational quality. ACEN supports the interest of nursing education, nursing practice, and the public.
Why is Accreditation Important?
Most states mandate that a nursing program be accredited.
It gives the program the opportunity to validate its commitment to providing a quality nursing program through a review of peers. Requires the nursing program to continuously assess and make improvements in the educational quality of the nursing program.
The program is evaluated by its Standards and Criteria. What is its mission, faculty, curriculum, resources, and outcomes?
Aids in student recruitment
Offers professional development
Graduates of ACEN programs outperform other graduates on Licensure and advanced examinations.
Disadvantages to a Student if not Accredited:
May not qualify for employment if an employer requires graduation from an accredited program.
Student may not qualify for federal funding or financial aid.
May not be able to be licensed as a nurse in some states.
(ACEN, 2021).
The AACN is leveraging its resources to secure federal funding for faculty development programs, collect data on faculty vacancy rates, identify strategies to address the shortage, and focus media attention on this important issue (AACN, 2020).
Faculty Retirement: Faculty age continues to climb with the average age of 50-62, and a wave of faculty retirements is expected across the U.S. over the next decade. One-third of the faculty workforce in the baccalaureate and graduate programs is expected to retire by 2025.
Higher Compensation In the Clinical Practice:
Higher compensation in the clinical and private sectors is luring current and potential nurse educators away from teaching.
Average salary of Master’s-prepared Assistant Professor was $79,444, whereas the average salary of a nurse practitioner across settings and specialties was $110,000.
Companies are offering sign-on bonuses
Retention bonuses and bonuses for working extra shifts.
AACN reports that in 2019 8,471 qualified applicants were turned away from master’s programs, and 3.157 qualified applicants were turned away from doctoral programs.
(AACN, 2020),
Strategies to address the Faculty Shortage
Recruit, support, and mentor faculty from diverse backgrounds.
Nurse Faculty Loan Program: covers all tuition and fees for students interested in becoming full-time nurse faculty. Under the program, the student’s loan is gradually canceled each year of full-time employment as a nursing faculty in a school of nursing anywhere in the United States.
Jonas Nurse Leaders Scholarship Program: allows the program to support two DNP students for two years with partial scholarships, one-on-one mentoring, and participation in leadership and projects.
(Feldman et al., 2015).
COVID-19
Nurse Burnout: Nurse burnout is now classified in the International Classification of Diseases and can be defined as the state of emotional exhaustion; the individual is overwhelmed by work, unable to face the demands of the job, and unable to engage with others. The impact of nurse burnout can compromise patient safety, reduce job performance, and have negative job performance.
Stress levels Many hospital employees were asked to move from their usual departments and roles to assist with the intensive care of COVID patients.
Stress Reduction: Encourage nurses to make rest a priority and engage in activities outside of work. Many institutions are encouraging Self-Care
Aging Work Force:
Between 2000-2018, the average age of employed RN was 42.7-47.9 years.
Over one million RNs will retire between now and 2030.
During COVID-19, hospitals stopped doing elective surgeries, and patients stayed away from the hospital leading to less income for hospitals. This caused hospitals to reduce staff and furlough employees, leading to some RNs opting to retire.
( USAHS, 2021).
Economic Challenges: Tuition fees and regression in financial aid programs pose obstacles to prospective candidates.
Staffing Ratios: Studies have found that lower nurse-to-patient ratios reduce patient mortality, reduce preventable medical errors, falls and injuries. They also reduce the length of patient stays and readmissions. Staffing Ratios improve nurses’ job satisfaction and reduce nurse turnover (Spring Arbor University, 2022). For nurses working in facilities where hiring is limited because of budget constraints, the shortage poses staffing and ratio issues, also contributing directly to burnout (Carlson, 2021).
Nurses are also reporting difficulty getting hired due to travel nurses receiving extremely high pay rates in hard-hit areas from the pandemic.
Life Expectancy
As baby boomers age, the number of older adults will be unprecedented in U.S. history, and by 2035 older people are projected to outnumber children for the first time in U.S. history ( Meola, 20220). The portion of the population on fixed incomes with high medical expenses will increase, resulting in the healthcare system, Medicare, and social security will come under an increasing financial strain ( Milken Institute School of Public Health, 2022).
Chronic Care Management
80 % of aged adults have at least one chronic condition, and 68% have two or more chronic conditions.
Top 5 Common Chronic Conditions for Adults Over the Age of 65: Hypertension, High Cholesterol, Arthritis, Coronary Heart Disease, and Diabetes. However, with the recent pandemic, we have to anticipate the need for the care of long haulers of COVID-19. These long haulers may vary in age (NCO,2022).
Proactivity through education can reduce patient visits and costs and improve health.
Financial Burden of Healthcare
Financial Barriers to Healthcare are Medicare’s Universal Coverage and Out-of-Pocket Spending.
Medicare’s Universal Coverage: Has significant cost-sharing requirements such as deductibles and coinsurance with no limit on out-of-pocket spending. The following services may not be covered and may require additional insurance plans: vision, hearing, dental and long-term care.
Out-of-Pocket Spending: One-fifth of older Americans spent more than $2000 out-of-pocket on healthcare in the past year. Older adults spend a large share of their fixed income on healthcare. This can present a challenge as older American adult report forgoing healthcare because of high costs. They reported skipping dental care and postponing non-urgent care, and they also reported that the high costs of prescription drugs led those on a fixed income to choose between eating and filling their prescriptions.
(Jacobson, 2021),
Telehealth
Provides healthcare without an in-person office visit.
Remote monitoring, such as a wearable device, allows healthcare providers to stay informed on the progress in real-time.
Opportunity for health equity. It provides the opportunity for everyone to receive healthcare and reach underserved communities.
Benefits: healthcare can be obtained wherever you are located, virtual visits cut down on travel time, time off from work, shortens wait time for appointments, and access to specialists located away from your hometown.
(HRSA, 2021).
Medicare programs have begun allowing more patients to do virtual checkups and get prescription refills.
With the increase in telehealth and virtual appointments it is essential that our nurses know how to incorporate the art of nursing. For example, making eye contact, touch, hand gestures and listening to patients. These are skills that need to be taught and developed and are worthy to be taught in our curriculum (Fawaz et al., 2018).
Nursing Informatics
Definition: Nursing Informatics is the science and practice that integrates nursing, its information, and knowledge with information and communication technologies to promote the health of people, families, and communities (ANI, 2022).
Nursing informatics was recognized by the American Nurses Association in 1992 and is continuously evolving. During the peak of COVID-19, nursing informatics was essential in managing and leading critical operations. An important role this technology played was that Nurse Analysts provided support and constantly managed the critical requests to keep the electronic health record aligned with the evolving public health recommendations and government regulations.
Distance Learning
Allows flexibility to view lectures and course material in an asynchronous format (Morelock, 2022). Online learning opens up the opportunity for single parents and those who do not have access to a nursing program locally to attend classes.
Now becoming an integral part of nursing education
Cultural Competence:
Cultural Competence is the ability of healthcare professionals to effectively meet the cultural, social, and linguistic needs of their patients.
The United States has a population of a rich cultural mix that includes people from around the world, bringing a mix of traditions and practices. The diversity of the population, along with the socioeconomic factors, has brought cultural competence in healthcare to the forefront.
Cultural Competence limitations: implies that culture is a technical skill in which clinicians can develop expertise, ignores the role of power, privilege, and racism in healthcare
Cultural Humility is defined by flexibility, a lifelong approach to learning about diversity, and recognition of the role of individual bias and systemic power in healthcare. Cultural Humility promotes self-evaluation and can be incorporated into nursing education. An example of a teaching strategy would be case studies with reflection. Using reflection allows the student to fill the gaps in skills and knowledge and encourages the student to question current practices.
(National Academies of Science et al., 2021),
