Implementing the Future of Nursing Recommendations

Describe how to become involved in efforts to advance the Future of Nursing Develop grassroots methods for spreading the Campaign for Action at participant’s organization Demonstrate increased awareness of current and planned initiatives to support the nursing and its impact on the Health of Texans

IOM Reports Health Care Reform-Affordable Care Act Primary Care Shortages Value-Based Purchasing Increased focus on Research and Evidence-based Care National Initiatives on Quality and Safety Care Coordination

1.Remove scope of practice barriers. 2.Expand opportunities to lead collaborative improvement efforts. 3.Implement nurse residency programs. 4.Increase the proportion of nurses with BSN to 80% by Double the number of nurses with doctorate degrees by Ensure that nurses engage in life-long learning. 7.Prepare nurses to lead change. 8.Build an infrastructure for the collection and analysis of workforce data.

Frontline Staff-What’s in it for me? – Over 500 page report from nurses-over 2 years of work – Transform Care Delivery – Platform that supports nursing’s commitment to Patient Care Coalition Efforts-Website updates Staff Newsletters Ties to Strategic Initiatives-Vision Staff Forums and Community Presentations

Engage and support recommendations for RWJF/IOM Future of Nursing Remove Scope of Practice Barriers Advance use of CNS-driven, population-focused programs, e.g. Stroke and Trauma Certifications Expand role of Unit Secretaries to Health Unit Coordinators Nurses to lead and diffuse collaborative improvement efforts Continue to improve nurse-to-physician relations as evidenced by increased collaboration/participation of physicians on key house wide initiatives Open and sustain advances in throughput with a Clinical Decision Unit Bridge the gap from academia and practice Build and sustain a mentoring program for new graduates based on Professional Practice Model and Magnet® Model Increase BSN rate to 80% house wide by 2015

Engage and support recommendations for RWJF/IOM Future of Nursing Prepare nurses to lead change Advance number of certified nurses to 50% Double the number of doctorate prepared nurse Embrace Evidence-Based Practice and Research Each unit will engage in 1 EBP/Research Study Enhance a culture of excellence by achieving key performance milestones that affect quality and safety Nurse sensitive metrics will continually improve and outperform national benchmarks: Fall prevention program promoting efforts to exceed NDNQI 25th percentile for number of falls per 1000 patient days Sustain and/decrease current rate of HAPU, CAUTI, CLBSI

Advanced Practice Nurses – Perryman Report fully supports the IOM stance that APN increase access, safety and continuity of care – Average cost of NP visit is 20-35% lower than the average cost of a physician office visit (MEPS) – No difference in malpractice rates among states National Council of State Boards of Nursing

Examining Our Practice-Remember it’s not just APNs… – What you or your colleagues doing that does not require your RN skill set? – What you or your colleagues not doing that we are great at doing? Care Coordination Working with State and Federal Regulatory bodies – National Council of State Boards of Nursing Transition to Practice – Texas Medical Association – Peers In Practice

Great Work Being Done! – California Study of Regulations – RWJF-Transforming Care at the Bedside Ways to Expand – Health Care Policy-Duty – Informatics – Customer Service-Advocacy – Certification – Education or Academic Partnerships

Meeting the Challenge to Improve the Care – Our ethical code requires it-Provision 8 “the nurse collaborates…” – Engaging those with similar goals Transforming Care at the Bedside Community Transition Programs Medical Services/Ambulances Geriatric – NICHE

IHI Triple AIM – Decrease Cost – Increase Satisfaction or the “patient experience” – Improve the overall health of the population Community partnerships-Community Health Action Team HCAHPS questions Care Coordination/Transition of Care – Clinical Nurse Leader Partnership-Avoid “acute care centric” – Social Services, Pharmacists, Physicians, Home Care, LTC

Not just a “product you purchase” – Advantages of formalized program Data/recruiting Not Just About Student Placement – Henry Street Project-Public Health It’s a Partnership! – AACN/AONE Guiding Principles for Practice-Academic Partnerships 1.Develop Formal Relationships – Advisory committees – Fellowship programs to advance EBP 2.Shared Visions/Mutual Goals – Dedicated Education Units – Externships

Why We Need – Increase recruitment and retention – Decrease cost for orientation and training Internships- “not just 15 weeks” – Mentorships – Journey to Professionalism – Teaching to ANA Standards of Care – ANA Code of Ethics Get Involved – Preceptor/Clinical Coach

What does this mean and why? – Managing complexity – Advancing EBP/Research – Lower mortality and failure to rescue rates Doesn’t mean forget about the ADNs – Pipeline for BSN enrollees – Often best option for minorities or low-income Student Experience – Clinical Placement software – Other opportunities/Other industries

Presbyterian Hospital of Dallas – Strategic Vision Academic Partnerships Recruitment and Retention Funding and Encouragement = Success! An increase of 12% in 1 year to 67% rate of BSNs Seton – Long-term strategy with Leadership Established Guiding Principles Increase BSN hire rate Increase Nursing retention rates Increase number of non-BSN nurses returning to school

Call to Action to Universities, Colleges and Hospital Systems The Doctor of Philosophy – Leads Research Efforts The Doctor of Nursing Practice – Translation and Promotion of Research into Practices – Clinical Specialist

Advance Education Certification in area of Specialty Attend Conferences Share locally

TONE/TNA-Improving EHR Education-HIT Nurses Members of Boards-Not just hospitals Boardroom presentations on Micro-level changes – Opinion Polls conducted by RWJF show many believe nurses should have more influence on improving quality of care and preventing errors Lean Methodology Support Shared Decision-Making

Keep Texans First Know your power but more importantly your responsibility Use Your Resources Know the Issues Get Involved – Are you the Carrot, the egg or the coffee??

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