Educational Challenges Changing Roles

E-Line Military

Diversity in Nursing Males Facts 11.4% of pre licensure students are male 9% of DNP students are male 7.5% of PhD students are male 6.2% are practicing nurses are male Many are in the military Issue Few role models and mentors Duke’s model

Ethnic Diversity in Nursing

Changes in Nursing Education Competency-based curricula Community colleges moving rapidly toward teaching concepts over the curriculum and not block courses. Examples Reduction in credit hours for both the Associate degree and the BSN Associate degree to 60 hours BSN to 120 hours Attempt to standardize the prerequisites.

Changes in Nursing Education Curriculum–major areas of focus in a “new” nursing education curriculum should include interprofessional collaboration, communication, and systems thinking. Life-long learning–nurses must keep up with new knowledge and new technology to ensure quality patient care.

Changes in Nursing Education Technology–simulations and other types of technology that encourage critical thinking and problem solving are important to adequately prepare the required number of nurses for the future. Articulation–curricula and educational programs should be structured to enable the learner to progress from basic to advanced education with minimal disruption.

Changes in Nursing Education Older adult care–given the shift in age range of the population of the United States, significant time and emphasis must be allocated to student learning about geriatric care, management of chronic conditions, and community-based practice. Technology–simulations and other types of technology that encourage critical thinking and problem solving are important to adequately prepare the required number of nurses for the future.

Changes in Nursing Education Articulation Professionalism – nursing education must include empowering students to be active players in the healthcare environment

Changes in Nursing Education Carnegie Report (Patricia Benner) Nursing education in the traditional formats is not working to prepare nurses to practice in today’s complex healthcare environment. The Carnegie Report on Nursing Education A report was issued early in 2010 (Benner, et al) from the Carnegie Foundation. This report was the culmination of several years’ worth of work by a group of stakeholders in the nursing education and practice environments. After thorough analysis of the current landscape of nursing education, the report concluded that education in the traditional formats is not working to prepare nurses to practice in today’s complex healthcare environment. A number of recommendations were made, including better articulation between programs. This would allow students to begin their healthcare careers as LPNs or associate degree graduates, then advance to baccalaureate or higher education with minimal “roadblocks.” Another recommendation from this report is that the curricula currently used by schools of nursing, focusing on performance of nursing tasks or skills, must be significantly changed. Rather, the focus of undergraduate education should be on development of knowledge, skills, and abilities to function in a complex healthcare system. Students entering nursing today need to be knowledgeable about topics such as leadership, cultural diversity, advocacy, and evidence- based practice. Subsequent to academic preparation, a nurse residency program is recommended. Residency for nurses, similar to that for new physicians, would enable the nurse to gradually increase knowledge and skills specific to the desired area of practice. Clinical practice would be combined with a continuation of formal learning opportunities to facilitate development of critical thinking and clinical judgment. A residency program is not the same as orientation or preceptor- based learning. The residency program is a formal blend of academic and clinical experiences that focus on application of knowledge and skills in the clinical setting, while continuing to learn and develop skills in interprofessional collaboration. Some residency programs are currently in use, and reports of their value have been positive.

Changes in Nursing Education Recommendations Better Articulation between programs the curricula currently used by schools of nursing, focusing on performance of nursing tasks or skills, must be significantly changed. Focus of undergraduate education should be on development of knowledge, skills, and abilities to function in a complex healthcare system. Students entering nursing today need to be knowledgeable about topics such as leadership, cultural diversity, advocacy, and evidence- based practice. Residency Programs

Interprofessional Collaborative Care The effect of Interprofessional Care Teams on Intensive Care Unit Mortality Likelihood of Death within 30 Days of ICU Admission ICUS without daily Interprofessional Rounds 19.1% ICUS with daily Interprofessional Rounds 16.2% A study of critically ill patients admitted to 1169 Pennsylvania hospitals over the course of two years found that daily rounds by an interprofessional ICU team were associated with a significantly reduced risk of death.

Conventional VS Collaborative Care Authoritarian Autonomous practice culture Physician Driven, MD’s responsible for outcomes Episodic, fragmented Primary Care delivered in one size fits all 15 min Payment based on quantity (fee for service) Reactive, Focused on illness Communication is inconsistent Collaborative Care Collaborative Team Culture Patient centered, with team members sharing responsibility for outcomes. Continuous, coordinated Primary care delivered via ind. Visits, phone calls, and online communications Payment based on value Preventive, focused on health Communication is imperative

Core Competences for IPC Values/ethics for Interprofessional Practice Mutual respect Shared values Roles/Responsibilities for Collaborative Practice Use knowledge of one’s own role and those of other professions Assess and address the health care needs of patients and populations served. Interprofessional Communication Communicate with patients, families, communities, and other health professional in a responsive and responsible manner that supports a team approach in maintenance of health and treatment of disease Interprofessional Teamwork and Team-Based Care

Interprofessional Teamwork Interprofessional Teamwork and Team-Based Care Apply relationship –building values and the principles of team dynamics to perform effectively in different health roles to plan and deliver patient population centered care that in ss safe, timely, efficient, effective , and equitable.