Nursing Academic Progression in Idaho Sponsored by matching grants from the Idaho Board of Nursing and RWJF/AARP

Defining Academic Progression Academic Progression is defined as progress towards (1) achieving the Idaho endorsed national goal of an 80% BSN educated nursing workforce and (2) doubling the number of doctoral educated nurses, both by 2020.

Background Reviewing Academic Progress INAC sponsored national speaker and workshop at NIC in February. BSU and LCSC with application partnership ISU to refocus the RN to BSN track BSU has graduated 800+ RN to BSN Non-legislative appropriated funding model BSU has dual enrollment with CWI, CSI, NIC, TVCC, EITC BSU with 700+ currently enrolled students in RN to BSN NIC increased participation in LCSC dual enrollment. LCSC increased partnerships with CWI, TVCC and negotiating with Walla Walla for dual enrollment.

Doctoral Education in Idaho Idaho State University graduated first PhD in nursing May 2016. 9 more students are enrolled Idaho State University graduated the first 8 Doctor of Nursing Practice (DNP), all FNP, May 2016. 16 FNP and PMHNP students are enrolled Boise State University graduated first 5 DNP students in May 2016.

Background Idaho’s endorsed IOM goals in 2015 “Nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression” Increase proportion of nurses with BSN degree to 80% by 2020 Double the number of nurses with a doctorate by 2020

Background Reviewing Academic Programs and Progression incentives 9 current programs offer RN education Statewide Articulation Agreement previously implemented 2004-2008 Early adopter of statewide on-line education Multiple education methodologies in Idaho Sporadic partnerships between education and industry Inconsistent employment incentives to obtain a BSN

Transforming Nursing Education Five Promising Models Nationally RN-to-BSN Degree Awarded from a Community College Shared Statewide or Regional Curriculum Accelerated Options: RN to MSN and others State or Regionally Shared Competency or Outcomes-Based Curriculum CC/University partnership: first 2 years of BSN from CC, second 2 years at University.

RN-to-BSN Degree Awarded by a Community College Seamless academic progression Higher volume: potential major BSN producer Offers wider geographic reach Moderate costs AD nurses can work while pursuing BSN Idaho already allows this program, but because CC are locally funded, barriers to CC expansion need evaluation and community support Catching on across the nation as CC presidents see this as a way to preserve their nursing programs. For place bound students very important but takes a lot of work. Eg. Washington

Accelerated Options i.e. RN to MSN Enables AD students to move efficiently into leadership, teaching, advanced practice & research roles Values the practice experience of AD nurses Often includes substantial online component Improved efficiency & flexibility for students: reduces duplication of coursework & speeds progression Facilitates inclusion into nursing of students with more varied backgrounds Must include BSN essentials content Transparency of “step-out” option is very important Idaho has one current program at NNU Must include the essentials of baccalaureate level content. Some programs have a step out at the BSN level, needs to be transparent

State or Regionally Shared Competency or Outcomes-Based Curriculum Strengthens partnerships across academic institutions and with practice partners, as consensus is reached on a unified set of competencies Allows removal of redundant content and increases transparency, with outcomes leveled and benchmarked throughout the curricula via consensus Competencies may be incorporated into shared curriculum but shared curriculum is not required: Individual institutions may adjust teaching delivery Defines the outcomes not the pathway We don’t care about which courses to get here, we care about the destination. Not talking about Western Governors (testing out) . Asks where in the curriculum the content is. Agonizing to watch, long comparison, and gap analysis. Defining the pathway not the outcome.

Shared Statewide or Regional Curriculum Facilitates seamless academic progression Creates an educational collaborative between academic institutions Schools may share entire or partial curriculum, as well as faculty, simulation facilities Reduced faculty workload: better use of resources Reduction in duplicative coursework for students Simplifies advising Dual enrollment is also one example of shared curriculum Includes GE requirements Start by talking about the barriers….pre-requisites, on-line coursework, grad. req. from the university etc. 1 (university), 2 ADN, 1 (University for public health etc)

Closing the BSN Gap Responsible Stakeholders Nursing Education Programs- doing their part AD to BSN options at all 4 year schools. Dual enrollment models exist in Idaho. Idaho with high NCLEX pass rate Open to additional creative education solutions Industry—employers of nurses—can do more Tend to value the license & certifications more than degree (except TV, EIRMC and KH hospitals) Education incentives strain limited resources and often are not enough for students Individual nurses—support, encouragement, resources Overcoming barriers; need counselling and financial support Where the nurse lives influences decision to go on Work culture effects their vision for themselves

Closing the BSN Gap Methodologies Support existing RN to BSN on-line programs because they show success and impact Idaho’s BSN numbers. Expand dual enrollment regionally to include Walla Walla Community College, TVCC and other Idaho Community Colleges. Promote the shared application approach. Support curriculum revisions for common pre-requisites and core courses.

Workforce Assessment Methodology National Data Idaho Data Based on a sample of RN conducted every 2 years Each state calculates the number differently Resident RN only versus all RN licensees Inactive licenses not counted Variable if not working not looking counted or not. Based on 3 data sources Idaho Board of Nursing Nurse License Database Idaho School of Nursing Report to Board of Education Employment report to Dept of Labor from employers. Data is date variable—average more than 100 licenses processed monthly.

2015 Idaho RN Workforce Report Meeting Job Demand Outward migration of 339 new graduate nurses. Average annual shortage of 120—could be demand for experienced RN

What is Idaho’s BSN Number Today? 67.14%

Methodology to Determine Idaho RN BSN Numbers DATA 2015 RENEWAL [RECENT] Feb 2016 Adjustment OVERALL TOTAL ACTIVE RN LICENSE 18763 19416 Active license but Employed Outside Nursing 796 809 Active license but not employed, no plans to work as RN 2237 2263 Out of State Resident 3024 3140 Total resident workforce 12706 13204 Resident BSN/MSN/DNP/PhD 8634 8866 % BSN 67.95% 67.14%

Idaho RN Age Over 55 years with active license = 6,759 Represents 34.8% of all 19,416 licensed nurses. **Note—cannot yet determine age range with degree or by zip code. Nationally—older RNs more commonly have Associate degree, so attrition helps the BSN %, but the large number is negative on workforce demand.

Proposed Future Focus Employers target roles requiring BSN in workplace. Outcomes benefit of higher degree preparation. Continue removing academic progression barriers. Increase support mechanisms for students. Close monitoring of workforce composition and demand.

Next Steps Clarify Plan Content. Work with IDOL and BON for the January 2017 Idaho Nursing Workforce Report. Support collaboration between employers and education. Support schools with curriculum updates. Promote decreasing barriers for students in all venues.

Thank you