American Pacific Nursing Leaders Council Report to the Pacific Island Heath Officers Association Board of Directors Meeting August 31, 2016 Honolulu Hawaii Kristine Qureshi, RN, PhD, FAAN Professor and Associate Dean, Research and Global Health University of Hawaii at Manoa School of Nursing and Dental Hygiene

Key activities of the APNLC during 2015/16 June 20-24, 2016 APNLC Annual Meeting Education Committee ongoing work Pacific Island Network of Nursing Program Directors groups ongoing work Chief Nurses Committee ongoing work Research Committee ongoing work Centennial celebration of nursing in American Samoa

APNLC Annual Meeting The annual APNLC meeting was hosted by the Republic of the Marshall Islands In Majuro. (June 20-24, 2016) Groups that had been working via distance had a opportunity to work in person and dialogue extensively about ongoing projects, issues and opportunities

Five year APNLC strategic plan APNLC has a 5 year strategic plan 2012-2017 Key elements address: Non communicable diseases Emerging and re-emerging infectious diseases Nursing Education Quality Assurance Practice/Standards/Policy Specialty Nursing Practice Connectivity

Education Committee and PINNED Work PREPARATION OF HS GRADUATES: HS graduates are not adequately prepared for CC academic work in nursing. Specific difficulties with English & Math skills. Palau Community College (PCC) and Northern Marianas College (NMC) has also been working closely with public school systems EMPLOYMENT OF NEW GRADUATE RN’S: New graduates from the local community colleges need to be able to secure employment as a nurse as soon as they graduate. Currently in some jurisdictions employment is often delayed (usually related to funding) If you invest in educating a nurse, be sure you have a job for them CAREER LADDER FOR ADVANCED DEGREE IN NURSING: A structure for such needs to be developed so that there are articulated roles for BS, MS (and ultimately NP and PhD prepared nurses) The whole system needs to understand the role

Chief Nurses Committee ongoing work Key focus is nursing workforce assessment relative to needs in terms of numbers and skill mix. Precursor to such assessment is understating patient volume, type and levels of nursing care required. 1. Developed a simple tool to assess acuity of nursing intensity requirements in hospitals; validated the tool in Yap and Palau (each can actually use the tool now) 2. Reviewed at APNLC by other Chief Nurses 3. Will be rolled out to RMI (Majuro and Ebeye, and FSM) in December Based on the above information, skill mix and numbers of nurses can actually then be calculated using pre set ratios

Research Committee ongoing work Extension of a PhD project from K. Wood, (UOG faculty member) . Examined factors that influence breastfeeding among Chuukese women who relocate to Guam. APNLC Research committee will now examine breastfeeding patterns and factors that influence exclusive vs. bottle feeding of newborn infants across FSM. Funding from the APNLC Research Committee fund and in kind from UH

So… Where are the opportunities to strengthen nursing in the USAPI? Include nursing at the policy table Really examine what nurses do in each jurisdiction Assure that there are realistic standards of nursing care, implement a quality improvement program that maps to established standards, follow through on response to findings Strengthen the ongoing education endeavors such as the RN to BS program supported by many of the jurisdictions Expect and support inter-professional collaboration, assure that ex-pat professionals hired understand inter-professional collaboration Invest in community health sector nursing, (as chronic NCD’s and larger numbers of elders will shift care from hospital to community- where the care is often better, and costs are much lower) Mahalo!