1. Kentucky Nursing Capacity Consortium Update
Kim Dees, MSN, RN, MBA/HCM
Kentucky Hospital Association
Vice President of Health Professions
Sherry Holmes, MSN, RN
University of Kentucky College of Nursing
Coordinator of Assessments and Special Projects
Kentucky Organization of Nurse Leaders 8th Annual Conference
September 21, 2012 Louisville , Kentucky

2. Objectives Provide a brief overview of the 2010
IOM Report recommendations on the future of
nursing
Describe the current activities of the Kentucky Nursing Capacity Consortium (KNCC)
Summarize the outcomes of the
Pilot: Supporting Transition to Practice in
Rural Kentucky

3. Institute of Medicine October 2010 Report: The Future of Nursing Leading Change, Advancing Health
Remove scope-of-practice barriers
Expand opportunities for nurses to lead and diffuse collaborative improvement efforts
Implement nurse residency programs
Increase the proportion of nurses with a baccalaureate degree to 80% in 2020
Double the number of nurses with a doctorate by 2020
Ensure that nurses engage in lifelong learning
Prepare and enable nurses to lead change to advance health
Build an infrastructure for the collection and analysis of interprofessional health care workforce data

4. Relationship of KNCC and Kentucky Action Coalition
KNCC applied to and was selected by the Future of Nursing Campaign for Action to become the Kentucky Action Coalition (KYAC) (9/23/2011)
is the website for the Campaign for Action
Early October the website will be upgraded to have a link to the KYAC for progress reports

5. KYAC Goals and Objectives
Short term goal - position KYAC to achieve long- term goals (Fall 2011-Fall2012)
Establish plan for strengthening stakeholder base
Develop media plan to influence public and health professions awareness of the IOM Report and KYAC
Complete Rural Residency Pilot and determine need for statewide implementation

6. KYAC Goals and Objectives
Long term goal - Kentucky will have a highly educated nursing workforce that can practice at full scope (12+ months)
Actively engage Kentucky nurses in policy making
Reduce barriers for APRN practice
Increase percentage of BSN and doctorally prepared nurses
Develop tracking mechanisms to measure outcomes of our work

7. IOM Recommendations: KYAC Focus/KNCC Activities
Barriers to APRN Practice
80% BSN by 2020

8. IOM Recommendations: KYAC Focus/KNCC Activities
Barriers to APRN Practice

9. Kentucky Statutes: Impact on APRN Practice
Prevent APRNs from ordering some services and performing certain exams
Prohibit reimbursement or provide reduced reimbursement – Medicaid reimburses APRNs at 75% of the physician rate
Complexity of laws produces confusion
Kentucky APRNs may practice independently; however, they must have a Collaborative Agreement for Prescriptive Authority in order to prescribe medications

11. Legislative Update 2012
HB 512 and SB 190 bills, which would have removed the requirement that advanced practice registered nurses have a collaborative agreement with a physician in order to prescribe non-scheduled drugs, did not pass during the most recent legislative session. HB 512 did make it through the approval process within the House. SB 190 was not heard in the Senate.
Advocacy work resulted in additional House and Senator champions for the issue and the plan is to reintroduce the legislation in the next session
Legislative leadership worked with nursing to get the necessary changes made to HB 4 (This bill incorporated increased use of KASPER for reporting and monitoring prescriptions)

12. Legislative Preparation 2013
In follow‐up to House Bill 1, the Kentucky Board of Medical Licensure has issued a 39 page document for regulation of prescribing and dispensing medications which is being circulated around the state for comment
Dr. Ardis Hoven (from Lexington) has been elected president of the AMA which may impact the activity of KMA to assure that nothing happens in Kentucky that is in opposition to the AMA agenda

13. Legislative Preparation 2013
Pay close attention to those running for election this fall in order to determine who nursing should support
The many calls made by KNCC and KNA during the session were positively noticed by the legislators and their staff
Nursing leaders need to be knowledgeable regarding the legislation that impacts nursing practice so that they can easily educate others
VOTE

14. IOM Recommendations: KYAC Focus/KNCC Activities
80% BSN by 2020

16. Kentucky (2008 National Sample Survey of RNs)
Est. #
% Diploma
% ADN
KY Est. #
% BSN
% MSN/ Doctorate US
2,596,599
12.1%
37.6%
37.3%
13.0%
Kentucky
41,520 -
54.1%
22,475
29.8%
12,354
11.4%
4,748

17. Kentucky Licensure Statistics September 2012
Kentucky Board of Nursing RN Current Licensure Count - By Educ. Level & County of Residence
Diploma Nsg/RN
Associate Degree/Nsg
Associate Degree/Non-Nsg Field
Baccalaureate/
Nsg
Non-Nsg Field
2927
31289 46
18559
1867
Masters/Nsg
Masters/
Non-Nsg Field
Doctorate/Nsg
Doctorate/
5823
1254
266
220

18. RN-BSN Kentucky AACN, 10 Schools reporting
Enrolled 708
Graduated 217

19. RN-BSN: Barriers to Progression
Exploring barriers to academic progression for Associate Degree nurses
Completed an audit of 11 anonymous transcripts from the technical and community college system
Plan developed with the technical and community college system Associate Degree programs to modify their programs to assure that all graduates are “core certified” in order to reduce the number of credits required at a state supported RN-BSN program in KY

20. Pilot: Supporting Transition to Practice in Rural Kentucky
One year project designed to assist new nurse in the transition from student to practice
Four major components:
Support sessions for the new nurses
Local mentoring
Educational modules delivered via web
Change Projects

21. Rural Residency Pilot: Findings
Pilot did not provide base line data or conclusive findings due to lack of participation
New nurses and mentors were not given paid time to participate
Information obtained and lessons learned are applicable to the design of future residency programs

22. Joint Education Conference
KBN and KNCC will hold a joint education conference this fall (November 30 tentative date in Louisville)
Nancy Specter, from the National Council of State Boards of Nursing will deliver the keynote, “Mind the gap: Best Practices for Accelerating the Practice Readiness of Nursing Students”
Participants: hospitals/employers and educators

23. KNCC/KYAC Priorities for 2012-2013
Accessibility of BSN programs
Legislation regarding prescriptive authority of APRN and Medicaid authority to improve access to healthcare for Kentuckians
Engaging more practice partners into the group
Look at the need for education of nurse educators (MSN for nurse educators)

24. In Conclusion
Commit to take action on recommendations from IOM report, this is about patient- centered care and health care reform, essential that nurses mobilize
Support nurses to advance their education
Optimize the voice of nurses in supporting Kentucky legislature to eliminate barriers to APRN practice

25. References
Institute of Medicine. (2011). The Future of Nursing Leading Change, Advancing Health. Washington, DC: The National Academies Press
Kentucky Board of Nursing RN Current Licensure Count - By Educ. Level & County of Residence. (September 18, 2012)
U.S. Department of Health and Human Services Health Resources and Services Administration. (September 2010) The Registered Nurse Population Findings from the 2008 National Sample Survey of Registered Nursing

26. Send email to janek@email.uky.edu
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