1. Future of Nursing Leading Change, Advancing Health
Title of Slide has a box to insert the appropriate aduience

2. 3.2 million 100,000 30,000 This is used to hook the audience.
There are 3.2 million nurses in the US. If we could all have a collective voice can you imagine what we could do. We are the largest profession in the healthcare field.
There are 100,000 nurses in VA
There will be a shortage of 30,000 nurses by 2020 if we continue to prepare at the rate that we do today based on increased demand with the greying (aging) tsunami and the increased number of insured by the Affordable Care Act.

3. Objectives To review Institute of Medicine, Future of Nursing Report
To define Campaign for Action
To define the Virginia Action Coalition
To describe the workgroups

10. IOM Future of Nursing Campaign for Action
The Institute of medicine Future of Nursing was released in October of It is the best body of evidence that we have on nursing and the future. It is 500 pages but has a very good executive summary that is 13 pages. It can also be downloaded from the IOM site or the RWJF site.

11. IOM Future of Nursing
Committee on The Robert Wood Johnson Foundation Initiative on the Future of Nursing
Membership
Opportunity to transform health care system
Provide seamless, affordable, quality care
Nursing profession is the largest segment of the health care workforce
How did it all get started. The RWJF spearheaded by Dr. Susan Hasmiller partnered with the Institute of Medicine to form a committee to investigate and make recommendations about the future of nursing. The membership consisted of Chair Dr. Donna Shalala former Secretary of Health and Human Services who is not Dean at the University of Florida. Dr. Linda-Burnes Bolton CNO of Cedar Sinai was the nurse who was most influential on the committee. There were only 3 nurses and all other members were physicians, economist, lawyers and other business representatives. The committee looked at this as an opportunity to transform healthcare and provide seamless affordable quality care since nursing as has been said is the largest segment of the health care workforce and we have been voted by the Gallup Poll on the most ethical and honest professions in the top for 13 consecutive years except for 911 when the Firefighters were number 1 and we were number 2.

12. Campaign for Action: Key Messages
Leadership
Access to Care
Workforce Data
Education
Interprofessional Collaboration
High-quality patient centered
care
There are 4 key messages in the IOM FON report and one thread that runs through. The four key messages are education, leadership, access to care and workforce data. The thread is interprofessional collaboration. And what we all know it takes a team to care for patients not just one profession can do it all.

13. Blueprint – Four Key Messages
Nurses should practice to the full extent of their education and training
Nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression
Nurses should be full partners, with physicians and other health professionals, in redesigning health care in the US
Effective workforce planning and policy making require better data collection and an improved information infrastructure
These are the definition of the 4 key messages…just review

14. Future of Nursing Recommendations
Remove scope of practice barriers
Expand opportunities for interprofessional collaboration
Implement nurse residency programs
Increase proportion of nurses with BSN to 80% by 2020
Double the number of nurses with doctorates
Ensure that nurses engage in lifelong learning
Prepare and enable nurses to lead change and advance healthcare
Build an infrastructure for data collection
These are the 8 recommendations and they are defined under each as to what can be done at the federal level, the state level and the regional or local level…review

15. Campaign for Action
The Campaign for Action is a national initiative coordinated through the Center to Champion Nursing in America (CCNA), an initiative of AARP, the AARP Foundation, and the Robert Wood Johnson Foundation.
The campaign has mobilized diverse stakeholders nationally and in all states to address the nation’s most pressing health care challenges – access, quality and increasing cost – by utilizing nurses more effectively and preparing nursing for the future.

16. Vision
Americans have access to high quality, patient-centered care in a health care system where nurses contribute as essential partners in achieving success
Reaffirm the vision

17. AARP Virginia Virginia Nurses Association

18. Virginia Action Coalition Co-Leads
AARP Virginia
David DeBiasi , RN, Associate State Director – Advocacy
VNA
Shirley Gibson, DNP, MSHA, RN, FACHE, President
Janet Wall, CEO
Each AC has to have a nursing lead and a non nursing lead. We had a great partnership and relationship with AARP and when they agreed to partner with us on the AC we were thrilled. David DeBiasi is wonderful to work with and he just happens to also be a BSN prepared nurse.

19. Virginia Action Coalition Goals
Nurses should practice to the full extent of their education and training
Nurses should achieve higher levels of education and training through an improved educational system that promotes academic progress and explore residency programs
Nurses should be full partners, with all members of the healthcare team in redesigning healthcare
Nurses should develop strategies to ensure that nursing is skilled to provide leadership at all levels
Nurses should ensure effective workforce planning and policy making require better data collection and an improved information infrastructure
When we wrote our grant to become an AC these were the 5 goals we set out.
Review.

20. Mission
To implement the recommendations in the Institute of Medicine report, The Future of Nursing: Leading Change, Advancing Health
Our Mission Read

21. Vision
All Virginians have access to affordable, high quality care and live in an optimal state of health
Our Vision read.

22. Virginia Action Coalition
Workgroups
In order to get our work done we have developed workgroups who meet on a monthly basis generally by conference calls.

23. VAC Leadership Lindsey Jones-Cardwell, BSN, RN and Loressa Cole DNP, MBA, RN Co-Leads
IOM Recommendation 7 Prepare and enable nurses to lead change to advance health Objective Determine strategic boards to which nurse could be appointed and work with stakeholders to identify, mentor, and recommend individuals for those appointments

24. Leadership Objectives
Continue “Nurse Leaders in the Boardroom” program piloted with Robert Wood Johnson and AARP in September, 2009
Continue to support Nurse Leadership Institute, a program of the Richmond Memorial Health

25. Outcomes
Networking and educational event for the nurses identified as 40 under 40
Recognized at VNF Gala
Mentoring event – May 31, 2012
Collaboration with:
VONEL
VNA
VNF

26. Outcomes
Survey to determine boards nurses are serving – regional, state and national
Survey also identified those wanting to serve on boards
334 Surveys completed
118 Experienced Nurse Board Leaders
181 Virginia Registered Nurses are future board leaders!
Video : Value of having a nurse serve on hospital board

27. Local Boards Free Clinics Crisis Pregnancy Centers
AORN, VNA, Black Nurses & other professional nursing associations
Public Health Advisory Commissions
Red Cross
Alzheimer’s Association
Church Affiliated Boards
Performing Arts Council
Historical Councils
County Board of Supervisors
AARP
University & Community College Councils
YMCA

28. State Boards Virginia Partnership for Nursing
Virginia Board of Nursing
Virginia Nurses Association
Virginia Nurses Foundation
Multiple professional nurses associations
Virginia Board of Health
Virginia Association of Counties
VCCS Associates Degree Nursing Program Heads
Virginia Association of Colleges of Nursing
Health Insurance Exchange Governing Body

29. National Boards
American Nurses Association & Political Action Coalition
National eHealth Collaborative
Nurses Organization of Veterans Affairs
American Midwifery Certification Board
AORN Journal Editorial Board
National Kidney Foundation
American Academy of Nurse Practitioners
American Organization of Nurse Executives
Various National Nursing Organizations

30. Next Steps
Survey hospitals to find boards where nurses serve Develop a video campaign value of nurse on
Enhance the Leadership Toolkit
Develop structure for mentors and mentees serving on boards
Publish Leadership Article with Campaign for Action
Blog for RWJF on Leadership
Leadership Development Conference for nurses who want to serve on boards

31. VAC Access To Care Cindy Fagan, RN, MSN, FNP-BC Kathy Baker, RN, PhD, NE-BC Co-Leads
IOM Recommendation 1
Remove scope-of-practice barriers
Objective
All nurses should practice to the fullest extent of their training
Objective Educate stakeholders, legislators and the public about APRN regulatory barriers that prevent full practice authority to continue efforts to  reform outdated scope-of-practice regulations

33. Outcomes House Bill 346 passed and signed by Governor
Eliminates supervisory language
Emphasized collaboration and consultation between NPs (LNP & CNMs) and physicians to practice in teams
Increased from 4 to 6 number of APRNs physicians can collaborate with
Joint Boards of Nursing and Medicine have 280 days from July 1 to develop regulations
HB 346 manifested in 2013

34. Outcomes
APRN Video has been completed

35. Next Steps
Continue education of the public about the APRN scope of practice
Conduct a gap analysis with all nurse practitioner roles in respect to the National Council of State Boards of Nursing Consensus Model
Meet with the Board of Nursing to review the NCSBN Consensus Model
Consider legislation to remove the Joint Board and establish an Advisory Group for oversight

36. Next Steps
Conduct research to explore how policies and practices in hospitals in the state of Virginia either support or inhibit RNs from practicing to their fullest extent through a Qualitative Descriptive Case Study rebased on Yin’s Methodology for Case Studies
Participants include nurses from all hospitals in the state
Areas include ICU, Med/Surg/Progressive Care and Emergency Department
Include the CNOs, RNs and Advanced Practice Registered Nurses
Nurses from select hospitals in the state of Virginia will be invited to participate. Nurses will purposively be selected to participate in a one hour focus. The nurses selected to participate should have worked on their current unit for the period of at least one year. The staff nurses selected should consist of at least one nurse from critical care, one from the general and/or intermediate care areas, and one from the Emergency Department. In addition, the staff nurses chosen should consist of at least one nurse who primarily works day shift and one nurse who primarily works night shift. If possible, the staff nurses chosen should represent a range of experience levels. In addition Nurse Practitioners from select hospital in the state of Virginia will be invited to participate in a separate one hour focus group.
Each staff RN, each NP and each CNO from participating hospitals will be asked to complete a demographic questionnaire in order to provide descriptive statistics for all of the participating hospitals and participants. The study investigators will conduct independent focus groups at each hospital using a semi-structured interview technique (See appendix A for interview questions). Informed consent will be obtained from each study participant prior to the initiation of the interviews.

37. Deb Zimmermann, DNP, RN, NEA-BC, Amy Gillespie, RN, MSN, EdD Co-leads
Education Progression
Deb Zimmermann, DNP, RN, NEA-BC, Amy Gillespie, RN, MSN, EdD Co-leads

38. VAC Education Progression
IOM Recommendation 4
Increase the proportion of nurses with a baccalaureate degree to 80 percent by 2020
Objective
Convene stakeholders on the implementation of seamless education progression

39. Future of Nursing Education
The Challenge
50% of VA RNs BS prepared
32% of AD graduates attain BSN
31% of Diploma graduates attain BSN

40. Outcomes Regional Groups
Eastern, Central, Northwest, North and Southwest
Inspiration to Aspiration
Interviews with nursing programs
RN-BSN Guide
Survey of RN-BSN students
Video of students
Academic Progression Models
Two statewide conferences with stakeholders
Shared models

41. Outcomes Community College statewide forum
Vice Chancellor of the Community College System
Forecasting Model
Policies regarding returning to school
2 years to enroll, 5 years to complete
Hiring BSN
CNO Survey
Tuition Assistance and scholarships
Flexible schedules and weekend programs

42. Outcomes Virginia Association Colleges of Nursing Meeting held
Awarded SIP Grant from RWJF
Supported Community Colleges continuing the work of collaboration for curriculum development
Provide support in policy development for education progression
Held Academic Progression Summit – March 28, 2014

43. Workforce Data Objective Nina Beaman, PhD, MS, RN-BC (PMH), RNC-AWHC and Richardean Benjamin, PhD, MSN, MPH, RN Co-Leads
Improve data collection and information infrastructure
Develop and implement specific geographical demand models for nursing and other health professionals

44. Next Steps Identify pilots for academic progression
Models from Campaign for Action
Develop mechanisms to track organizational progress for education progression

45. Outcomes
WHITE PAPER
Completed comprehensive white paper- Addressing Nursing Workforce Issues in the Commonwealth of Virginia
Finalized
Distributed

46. Outcomes
Continue participation on DHP Healthcare Workforce Data Center
Participation and dissemination of information from the VA Workforce Development Authority to inform AC workgroups
VHHA Workforce Development

47. Next Steps Serve as data experts to other workgroups
Assist VAC with compiling necessary statistics for any grant proposals

48. VAC Interdisciplinary Team-Based Care Patti McCue, ScD
VAC Interdisciplinary Team-Based Care Patti McCue, ScD., RN, MSN, NEA-BC Bonnie Barndt-Maglio, PhD, RN Co-Leads
IOM Recommendation 2
Expand opportunities for nurses to lead and diffuse collaborative improvement efforts
Objective
Develop and deploy an educational program that prepares nurses, physicians, and other care providers to practice in a team-based, patient-centered care model
Sallie/Patti

49. Outcomes Physician Foundation Grant
Expanded leadership program with MSV
Recruited 20 teams of physicians, nurses and other health professions
Completed Evolve Team Based Education
New partnership with VHHA/MSV/VAC

50. Members of the Virginia Action Coalition honored for their contributions to the nursing profession at the 2012 VNF Gala

51. Engage! www.virginianurses.com sgibson@mcvh-vcu.edu