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IOM :The Future of Nursing One Year Later Karen Barnes, RN, MSN December 2, 2011.

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Presentation on theme: "IOM :The Future of Nursing One Year Later Karen Barnes, RN, MSN December 2, 2011."— Presentation transcript:

1 IOM :The Future of Nursing One Year Later Karen Barnes, RN, MSN December 2, 2011

2 Most significant historical shift in nursing in this century. Beverly Malone, PhD,RN, FAAN NLN Executive Director Most significant historical shift in nursing in this century. Beverly Malone, PhD,RN, FAAN NLN Executive Director Health care reform legislation 2010Health care reform legislation 2010 Benner - Educating Nurses: A Call for Radical TransformationBenner - Educating Nurses: A Call for Radical Transformation Nursing Alliance for Quality Care establishedNursing Alliance for Quality Care established IOM report Oct. 5,2010IOM report Oct. 5,2010 Modern Health Care – nurse leaders among most influentialModern Health Care – nurse leaders among most influential

3 The Future of Nursing: Leading Change, Advancing Health RWJF & IOM partnership to assess & respond to need to transform nursing profession RWJF & IOM partnership to assess & respond to need to transform nursing profession Initiative on the Future of Nursing CommitteeInitiative on the Future of Nursing Committee Charge: recommendations for the future of nursing including changes in public and institutional policies - national, state and localCharge: recommendations for the future of nursing including changes in public and institutional policies - national, state and local

4 About the Institute of Medicine Independent, nonprofit organization working outside of government to provide unbiased advice to decision makers & publicIndependent, nonprofit organization working outside of government to provide unbiased advice to decision makers & public Mission: Serves as adviser to the nation to improve health.Mission: Serves as adviser to the nation to improve health. Process: expert consensus committeesProcess: expert consensus committees

5 Key Messages 1.Nurses should practice to the full extent of their education and training 2. Nurses should achieve higher levels of education through improved education system that promotes seamless academic progression.

6 3. Nurses should be full partners, with physicians & other health professionals, in redesigninghealthcare. 4.Effective workforce planning and policy making require better data collection & improved information infrastructure.

7 Message 1: Practice to full extent Regulatory barriers: scope of practice for APRNs varies widely by stateRegulatory barriers: scope of practice for APRNs varies widely by state High turnover among new graduate nurses requires focus on transition to practiceHigh turnover among new graduate nurses requires focus on transition to practice Expand residency programs beyond acute care settingsExpand residency programs beyond acute care settings

8 Message 2: Achieve higher education through seamless progression Multiple entry pathways debated 40 yearsMultiple entry pathways debated 40 years Competencies needed to practice have expanded, pressure on education systemCompetencies needed to practice have expanded, pressure on education system Care more complex in hospital and community settingsCare more complex in hospital and community settings More APRNs, faculty, and researchers needed to respond to patients needsMore APRNs, faculty, and researchers needed to respond to patients needs Increase diversity of the workforceIncrease diversity of the workforce

9 Message 3: Full partners in redesign Requires leadership competencies at all levels and embedded in all educationRequires leadership competencies at all levels and embedded in all education Nurses must see policy as something they can change vs. happens to themNurses must see policy as something they can change vs. happens to them All nurses must take responsibility for professional growth by developing leadership competenciesAll nurses must take responsibility for professional growth by developing leadership competencies Mentor others, develop partnerships and alliesMentor others, develop partnerships and allies

10 Message 4: Better data for workforce planning and policy making Strategic workforce planning hampered by lack of reliable and granular dataStrategic workforce planning hampered by lack of reliable and granular data Need projection by role, skill mix, region, and demographicsNeed projection by role, skill mix, region, and demographics

11 Recommendation 1: Remove scope of practice barriers For Congress: 1)Expand Medicare to include covering APRNs services as MD services covered 2)Authorize APRNs to certify HHH & SNF admissions 3)Extend Medicaid reimbursement for PCPs to APRNs 4)Limit funding for nursing education programs to states adopting NCSBN APRN rules and regulations

12 Recommendation 1: Remove scope of practice barriers For States: 1)Reform scope of practice regulations to conform to NCSBN APRN model 2)Require 3 rd party payors to provide direct reimbursement to APRNs

13 Recommendation 2: Expand opportunities for nurses to lead collaborative improvement efforts Private and public funders collaborate to advance research on models of care & innovative solutionsPrivate and public funders collaborate to advance research on models of care & innovative solutions Health care organizations support nurses in developing/adopting innovative modelsHealth care organizations support nurses in developing/adopting innovative models Nursing education and associations provide entrepreneurial professional developmentNursing education and associations provide entrepreneurial professional development

14 Recommendation 3: Implement nurse residency programs State boards collaborate with accrediting bodies to support completion of residency after prelicensure or advanced practice program OR when transitioning into new clinical areas.State boards collaborate with accrediting bodies to support completion of residency after prelicensure or advanced practice program OR when transitioning into new clinical areas.

15 Recommendation 4: Increase nurses with a baccalaureate degree to 80% by 2020 Academic leaders across all programs - partner with education accrediting bodies, funders and employersAcademic leaders across all programs - partner with education accrediting bodies, funders and employers Employers- encourage all RNs to enter baccalaureate programs within 5 years of graduationEmployers- encourage all RNs to enter baccalaureate programs within 5 years of graduation Federal agencies expand loans and grantsFederal agencies expand loans and grants $ $ $

16 Recommendation 5: Double the number of nurses with a doctorate by 2020 CCNE & NLNAC - monitor accredited schools to ensure 10% BSN graduates matriculate to masters/doctoral program within 5 yearsCCNE & NLNAC - monitor accredited schools to ensure 10% BSN graduates matriculate to masters/doctoral program within 5 years HRSA & Department of Labor - expand funding for programs offering accelerated graduate degrees $ $ $HRSA & Department of Labor - expand funding for programs offering accelerated graduate degrees $ $ $ Universities - create market competitive salary and benefit packages to recruit and retain nurse faculty $ $ $Universities - create market competitive salary and benefit packages to recruit and retain nurse faculty $ $ $

17 Recommendation 6: Ensure that nurses engage in lifelong learning Faculty & health care organizations – partner & prioritize competencies to ensure graduates meet health needs of the populationFaculty & health care organizations – partner & prioritize competencies to ensure graduates meet health needs of the population CCNE & NLNAC - require a comprehensive set of clinical competencies needed to provide care across all settingsCCNE & NLNAC - require a comprehensive set of clinical competencies needed to provide care across all settings

18 Recommendation 7: Prepare & enable nurses to lead change to advance health Nurses take responsibility for continuing education and seeking opportunities to leadNurses take responsibility for continuing education and seeking opportunities to lead Nursing associations - provide leadership development, mentoring, and opportunities to leadNursing associations - provide leadership development, mentoring, and opportunities to lead Public, private, and governmental health care decision makers include nurses in leadership positionsPublic, private, and governmental health care decision makers include nurses in leadership positions

19 Recommendation 8: Build an infrastructure for collection & analysis of interprofessional health care workforce data Federal agencies – lead collaborative effort to improve research on workforce requirementsFederal agencies – lead collaborative effort to improve research on workforce requirements The Workforce Commission & HRSA - set standards for collection of a minimum data set by state boardsThe Workforce Commission & HRSA - set standards for collection of a minimum data set by state boards Increase sample size and survey frequency; establish monitoring system to measure & project nursing workforce requirements by role, skill mix, region, & supplyIncrease sample size and survey frequency; establish monitoring system to measure & project nursing workforce requirements by role, skill mix, region, & supply

20 Next Steps Nursing organizations began initiatives to implement recommendations.Nursing organizations began initiatives to implement recommendations. RWJF & Center to Champion Nursing in America: national summit Dec 2010RWJF & Center to Champion Nursing in America: national summit Dec 2010 Future of Nursing: Campaign for ActionFuture of Nursing: Campaign for Action Purpose: implement IOM & develop Regional Action Centers (RACs) in each statePurpose: implement IOM & develop Regional Action Centers (RACs) in each state

21 Center to Champion Nursing in America Collaboration of AARP & RWJFCollaboration of AARP & RWJF Consumer driven initiativeConsumer driven initiative MISSION: ensure all Americans have access to highly skilled nurse, when & where they need one.MISSION: ensure all Americans have access to highly skilled nurse, when & where they need one. GOALS: build & sustain 21 st century workforceGOALS: build & sustain 21 st century workforce

22 Center to Champion Nursing Approach Convene multidisciplinary healthcare, business & consumer coalitionsConvene multidisciplinary healthcare, business & consumer coalitions Host national summits & forumsHost national summits & forums Develop a clearinghouseDevelop a clearinghouse Act as information resource on healthcare reformAct as information resource on healthcare reform

23 Regional Action Centers Groups of nursing & non-nursing leaders & stakeholdersGroups of nursing & non-nursing leaders & stakeholders Working at local, state & regional levels to implement IOMWorking at local, state & regional levels to implement IOM Began 2010: CA. MI, MS, NJ, NYBegan 2010: CA. MI, MS, NJ, NY Goal: one in each stateGoal: one in each state

24 IL Healthcare Action Coalition IL HAC Convened Feb. 2011Convened Feb Co-chairs: IL Center for Nursing (ICN) & IL Department of Commerce & Economic OpportunityCo-chairs: IL Center for Nursing (ICN) & IL Department of Commerce & Economic Opportunity ICN mission: advocate for nursing resources necessary to meet healthcare needs of IL citizens (established 2006)ICN mission: advocate for nursing resources necessary to meet healthcare needs of IL citizens (established 2006)

25 Resources Robert Wood Johnson Foundation: Wood Johnson Foundation: Institute of Medicine: of Medicine: Center to Champion Nursing in America to Champion Nursing in America Illinois Center for Nursing Center for Nursing

26 National League for Nursing: League for Nursing: American Nurses Association: Nurses Association: American Organization of Nurse ExecutivesAmerican Organization of Nurse Executives Illinois Organization of Nurse Leaders Organization of Nurse Leaders


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