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Future of Nursing - Fort Wayne

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A free seminar presented by University of Saint Francis - Fort Wayne

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Future of Nursing - Fort Wayne

  1. 1. Nancy GillespiePhD, RN, Dean Thank you.
  2. 2. Agenda Future of Nursing Presentation Panel Discussion Simulation Showcase
  3. 3. Mindy YoderDNP, FNP-BC, RNLeading Change, Advancing Health
  4. 4. Overview Healthcare challenges in the U.S. Our Nursing Profession Healthcare Reform IOM Nursing Report-Call for Leadership
  5. 5. What is the state of our HEALTHCARE SYSTEM?
  6. 6. A short list… Unsustainable costs Equitability of access to care Difficulty building consensus
  7. 7. A short list…cont. Care coordination Primary care shortage Aging population and rise of chronic disease Poor outcomes
  8. 8. Why does U.S.HEALTHCAREcost so much?
  9. 9. Why $$$? Technology Prices are higher in the United States Price insensitivity to end consumer Judgment-based nature of MD care Values and culture
  10. 10. Per capita health spending and 15-year survival for 45-year-old women. U.S. and 12 comparison countries, 1975 and 2005Muennig P A , Glied S A Health Aff2010;29:2105-113 ©2010 by Project HOPE - The People-to-People Health Foundation, Inc.
  11. 11. Demographics Starting in 201110,000 people in the U.S. have been turning 65 every day
  12. 12. Fastest Growing Population, 85+20,000 19,04118,00016,00014,000 14,19812,00010,000 8,745 8,000 6,597 6,000 5,751 4,000 4,240 2,000 0 2000 2010 2020 2030 2040 2050 Projected Number of Americans 85 years and over
  13. 13. Older Americans withMultiple Chronic Conditions Medicare beneficiaries with at least one chronic condition Nation’s healthcare spent on treating patients with chronic diseasesSource: AARP. ―Beyond 50.09: Chronic Care: A Call to Action for Health Reform.‖ Washington, DC. 2009
  14. 14. What is the state of NURSING?
  15. 15. A short list… Lack of nursing educational preparation to meet the demands of our current healthcare system Practicing clinicians regularly make decisions on tradition rather than empirical evidence Chronic, cyclical nursing workforce shortage Nursing faculty shortage, yet faculty are poorly compensated Shortage of doctoral nurses Education—practice gap
  16. 16. Projected shortfall in 20201million NURSES
  17. 17. The bottom line High-quality, patient-centered health care for all will require remodeling of health care system Three national healthcare goals (Donald Berwick) Improve health Enhance the patient experience Reduce/contain costs Nurses are essential partners in achieving success
  18. 18. The challenges beforeus require significantimprovement in publicand institutional policiesat national, state andlocal levels.
  19. 19. What is the impact of HEALTHCARE Reform?
  20. 20. Patient Protection and Affordable Care Act 2010 Health Insurance Reform • Expand insurance coverage • Expand consumer protections • Reform industry practices Status Quo • Health costs exceed general inflation • Sub-optimal population health • Unexplained Payment Reform, variations in Delivery Systems practice patterns • Evolve Medicare payment • Questions about systems from fee-for-service evidence base of to value based payment some procedures • Test new payment methodologies and patient care delivery models for Medicare, Medicaid & CHIPSource: Health Solutions Division,Manatt, Phelps & Phillips, LLP
  21. 21. Payment Reform, Quality, and Delivery System Change Timeline 2010 2011 2012 2013 2015 Shared Savings/ Dual New National pilot: Accountable Reduced Eligibles Center, Medic Bundled Health payment for Office are & Payments for Organizations hospital- established Medicaid Hospital & (ACOs) acquired Innovations post-acute care (FCHCO) conditions (CMMI) Reduced payments for preventable Estimate: these initiatives hospitalizations will reduce Medicare Value-based spending by $12b over purchasing 10 years for hospitals Independence at home demonstration projectSource: Kaiser Family Foundation
  22. 22. Evidence-basedrecommendations for education and practice.
  23. 23. Why Nurses? A high-quality health system will provide: • Chronic care management • Care coordination • Prevention and wellness • Care across the lifespan Nurses can help address these needs
  24. 24. The Future of NursingIOM Report Ensure that nurses can practice to the full extent of their education and training Nurses should achieve higher levels of education through an improved education system that promotes seamless academic progression
  25. 25. The Future of NursingIOM Report Nurses should be full partners with physicians and other healthcare professionals in redesigning healthcare in the United States Improve data collection and information infrastructure for workforce planning and policy making
  26. 26. 8 Recommendations Remove scope of practice barriers Expand opportunities for nurses to lead and diffuse collaborative improvement efforts Implement nurse residency programs
  27. 27. 8 Recommendations Increase proportion of nurses with BSN degree to 80% by 2020 Double the number of nurses with a doctorate by 2020 Ensure that nurses engage in lifelong learning
  28. 28. 8 Recommendations Prepare and enable nurse to lead change to advance health Build an infrastructure to collect and analyze healthcare workforce data
  29. 29. Growth in Doctoral Nursing Programs: 2006-2011 184 153 120 DNP 92 53 20 125 124 120Research-Focused Doctoral 116 111 103 0 20 40 60 80 100 120 140 160 180 200 2011 2010 2009 2008 2007 2006 Source: © American Association of Colleges of Nursing. All Rights Reserved
  30. 30. Enrollments in DNP & Ph.D. Programs: 2003-201110000 9000 9,094 8000 7000 7,037 6000 5000 5,165 3,927 3,982 3,976 4,907 3,718 4,161 4,611 4000 3,439 3,229 3,415 3000 2000 1,874 1000 862 170 329 70 0 2003 2004 2005 2006 2007 2008 2009 2010 2011 Research Focused Doctoral Doctorate of Nursing Practice Source: © American Association of Colleges of Nursing. All Rights Reserved
  31. 31. Better CareHealthyPeople/Healthy Affordable CareCommunities
  32. 32. Mindy YoderDNP, FNP-BC, RN myoder@sf.edu 260-399-7700, ext. 8510
  33. 33. Dave JohnsonPhD, CNS, BC, USF ProfessorLocal, State and National Perspectives
  34. 34. PanelistJudith A. Boerger MSN, MBA Sr. Vice President, Chief Nursing Executive, Parkview
  35. 35. Panelist Judith A. Halstead Ph.D., RN ANEF, FAAN Professor and Executive Associate Dean for Academic Affairs, IU School of Nursing,Indianapolis, President, National League of Nursing
  36. 36. PanelistKimberly J. Harper, MS, RN Executive Director, Indiana Center for Nursing
  37. 37. Panelist Karra Heggen, MSN, RN Chief Nursing Officer, Dupont Hospital, Representing Lutheran Health Network
  38. 38. Panelist Amy Knepp, NP-C, MSN Chair, Department of Nursing and Assistant Professor, University of Saint Francis, Family Nurse Practitioner for Parkview Physicians Group
  39. 39. Panelist Diana Dee Swanson MSN, NP-C NP IU Health Southern IndianaPhysicians Group, Representing Coalition of Advanced Practice Nursing in Indiana
  40. 40. The Future of NursingIOM Report Ensure that nurses can practice to the full extent of their education and training
  41. 41. The Future of NursingIOM Report Nurses should achieve higher levels of education through an improved education system that promotes seamless academic progression
  42. 42. The Future of NursingIOM Report Nurses should be full partners with physicians and other healthcare professionals in redesigning healthcare in the United States
  43. 43. The Future of NursingIOM Report Improve data collection and information infrastructure for workforce planning and policy making
  44. 44. Dawn M. MabryMSN, RN, CNESimulation and the Future of Nursing
  45. 45. History 2005 Simulation Lab Planning 2007 Simulation Experiences 2008 and 2011 iStan and Metiman
  46. 46. Demonstration Basic Assessment of a Teenage Athlete with Fluid and Electrolyte Imbalance
  47. 47. Roles Patient – Metiman Patient Voice – Jeb Ray, BSN student Registered Nurse – Janine Shane, BSN student Football Coach – Dr. Dave Johnson, faculty
  48. 48. Learning Objectives Performs an accurate basic physical assessment of the patient with fluid and electrolyte imbalance (APPLICATION). Identifies normal and abnormal assessment findings (APPLICATION). Documents normal and abnormal assessment findings in relation to fluid and electrolyte imbalance (APPLICATION).
  49. 49. Learning Objectives Identifies strategies for treating dehydration related to heat exhaustion (APPLICATION). Identifies teaching opportunities regarding heat-related illnesses (APPLICATION).
  50. 50. Prep Questions Describe the pathophysiology of dehydration. Which types of dehydration are most often associated with heat-related illnesses? What electrolyte findings are common with these types of dehydration? What assessment findings are consistent with dehydration? Describe the difference between heat cramps, heat exhaustion and heat stroke. How do symptoms and treatments differ for these three heat-related illnesses? What are the signs of rehydration?
  51. 51. SynopsisThe learner will be providing care for a 19-year-old male admitted to the Emergency Department(ED) for dehydration and electrolyte imbalancecaused by heat exhaustion. The patient is a starathlete on his college football team. He passedout this afternoon during practice. Thetemperature was 90 F, and the relative humiditywas 80%. It is August, and the team has beenpracticing for the last week.
  52. 52. Initial healthcareprovider’s orders Admit to Emergency Department CBC and Electrolytes, BUN, Creatinine, Glucose, STAT Start IV and give 500 mL 0.9% normal saline bolus Orthostatic blood pressures Notify of urine output of less than 30 mL/hour Oral fluids as tolerated
  53. 53. Debriefing Introduction: Discuss faculty role as a facilitator, expectations, confidentiality, safe environment for discussion Personal Reactions: Allow learners to recognize and release emotions, explore learner reactions Discussion of Events: Analyze what happened during the SCE, using video playback if available Summary: Review what went well and what did not, identify areas for improvement and evaluate the experience
  54. 54. StandardsInterprofessional the Future ofTeam Simulation NURSING EDUCATIONResearch

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