UNDERSTANDING THE AANN FUTURE OF NURSING WHITE PAPER: CHANGES TO THE AANNs FUTURE A white paper is an authoritative report or guide that helps members understand an issue, solve a problem, or make a decision, This is AANNs first White Paper that was created as a response to the IOM Future of Nursing report. This power point presentation will provide an overview of AANNs White Paper “Integrating the Institute of Medicine Future of Nursing Report into the American Association of Neuroscience Nurses Strategic Plan”

INTRODUCTION: HEALTHCARE REFORM March 2010: President Barack Obama signed into law the Patient Protection and Affordable Healthcare Act (PPACA) As we know, 2010 was a galvanizing year in healthcare policy. President Barack Obama signed into law the Patient Protection and Affordable Healthcare Act (PPACA) on March 23, 2010. This law is the principal part of healthcare reform of the private and public health insurance programs. It increases insurance coverage for preexisting conditions and aims to expand access to insurance for more than 30 million Americans. This additional demand for health services will alter the current health care environment and require changes in practice to meet the needs for quality healthcare.

INTRODUCTION: HEALTHCARE REFORM & NURSING October 2010: The Institute of Medicine Published a report “The Future of Nursing: Leading Change, Advancing Health” Four Key Messages 1. Nurses should practice to the full extent of their education and training 2. Nurses should achieve higher level of education and training through an improved education system that promotes seamless academic progression 3. Nurses should be full partners, with physicians and other healthcare professionals in redesigning U.S. healthcare 4. Effective workforce planning and policy making require better data collection and an improved information infrastructure Subsequently, in October 2010, the Institute of Medicine (IOM) released the report, The Future of Nursing: Leading Change, Advancing Health. This 2-year project highlights the urgency for nurses—the largest part of the healthcare workforce at 3 million strong—to become proactive regarding changes that are needed to prepare for future needs in health care. This 671 page document call for nurses as individuals, and as a profession, to lead and embrace change to meet the future demand for safe, high-quality, patient-centered, and equitable health care services. Four key messages are discussed in the report and are listed above.

INTRODUCTION: AANN RESPONSE July 2011: AANN Board of Directors (BOD) Adopted the 4 key messages of the IOM Future of Nursing call to action and integrated them into the AANN strategic plan. June 2012: AANN published its first White Paper “Integrating the Institute of Medicine Future of Nursing Report into the American Association of Neuroscience Nurses Strategic Plan” The AANN BOD recognized the urgency for a proactive response to the IOM Future of Nursing call to action and reviewed the current strategic plan and integrated the 4 key messages. AANN has followed up their initial actions with publication of the white paper to provide neuroscience nurses a blueprint for change.

Key Message #1: Nurses Should Practice to the Full Extent of Their Education and Training The following will discuss the first key message of the IOM Future of Nursing report and the integration of this key message into the AANN strategic plan. The first key message of the IOM is that “Nurses should practice to the full extent of their education and training”. Under this key message are two subcategories….

Key Message #1 What does this mean for AANN members? Neuroscience nurses must be able to practice to the full extent of their education regardless of whether they are working as a registered nurse or an advanced practice nurse; and regardless of the setting.

Key Message #1: Nurses Should Practice to the Full Extent of their Education and Training Subcategory 1: Scope of Practice Subcategory 2: Transition to Practice (Nurse Residency) programs Revision of the American Association of Neuroscience Nurses (AANN) Scope and Standards of Practice for Registered Nurses and advanced practice registered nurses (APRNs) Implement multilevel residency programs to manage entrance into neuroscience nursing (e.g., student to practitioner). Programs to manage positions of greater oversight (e.g., practitioner to coordinator, coordinator to director). “Neuroscience Nurses” should practice to the full extent of their education and training. Two subcategories will help to address this key message. The first is Scope of Practice. AANN needs to recognize both Neuroscience RNs and APRNs. For this reason, the AANN strategic plan created a task force to update its scope of practice standards document. APRNs will now be included in the AANN scope of practice standards.

Key Message #1: How can AANN accomplish this? Collaborate with the American Nurses Association (ANA) on the scope and standards of practice document. Support ANA scope and standards of practice updates. Disseminate the revised scope and standards of practice document to key stakeholders. AANN will support “Scope of Practice” through the following: collaborating with ANA on the scope and standards document, supporting ANA scope and standards updates and disseminating the revised scope and standards document to key stakeholders.

Key Message #1: Nurses Should Practice to the Full Extent of their Education and Training Subcategory 1: Scope of Practice Subcategory 2: Transition to Practice Programs Support the implementation of multilevel residency programs to manage entrance into neuroscience nursing (e.g., student to practitioner). Support programs to manage positions of greater oversight (e.g., practitioner to coordinator, coordinator to director). Integration of the American Association of Neuroscience Nurses (AANN) Scope of Practice for advanced practice registered nurses (APRNs) with those of bedside nurses to support excellence in the neurosciences. Again, “Neuroscience Nurses” should practice to the full extent of their education and training. Two subcategories to address this issue have been developed. The first, Scope of Practice, has been discussed. The second is implementation of “Transition to Practice” Programs. Because of the changing roles in which neuroscience nurses practice, there is a need to support transition to the neurosciences through residency programs to encourage and prepare APRNs to work in the neurosciences. Also, neuroscience APRNs should be encouraged and prepared to manage positions of greater oversight in order to be nursing leaders in the changing healthcare system.

Key Message #1 How can AANN accomplish this? Support transition-to-practice graduate nurse residency programs. Support the development of a competency-based transition-to-practice (nurse residency) program for entry into the neuroscience nursing subspecialty. Support and facilitate the implementation of multilevel nurse residency programs across the continuum of care. Prepare an AANN position statement on competency-based transition-to-practice (nurse residency) programs for neuroscience. Disseminate the AANN position statement to key stakeholders. AANN recommends integratrating the “Transition to Practice” goals through the following: support transition to practice graduate residency programs for APRNs, develop transition to practice programs for entrance into the neuroscience subspecialties, support residency programs across the continuum of care, prepare a position statement regarding such programs and disseminate the position statement to key stakeholders.

DISCUSSION Who are your key stakeholders? How do you disseminate information to stakeholders?

Key Message # 2 Nurses should achieve higher levels of education and training through an improved education process that promotes seamless academic transition.

Key Message #2 What does this mean for AANN members? We need to have opportunities for higher levels of education specific to neuroscience nursing. We need to have quality educational resources that support our educational needs.

Key Message #2 How can AANN accomplish this? Achieve industry-wide reputability as a producer of quality education products Foster a culture of lifelong learning AANN is a continuing education provider Support the use of traditional and alternative educational methodologies Face to face, online, distance, simulation Support development of a comprehensive core of clinical performance competencies Continue to disseminate research-based best practices AANN Clinical Practice Guidelines (CPGs) Journal of Neuroscience Nursing A key objective in the AANN strategic plan is to achieve industry-wide reputability as a producer of quality education products. AANN fosters a culture of lifelong learning and is a continuing education provider. It is important that AANN support a variety of traditional and alternative educational offerings to support lifelong learning for neuroscience nurses

Key Message#2 How can AANN accomplish this? Explore the global market to provide education in neuroscience nursing Create opportunities for entrepreneurial professional development education Enables neuroscience nurses to consider starting businesses intended to improve healthcare outcomes Disseminate innovative evidence-based care models Explore opportunities and introduce new educational products The strategic plan of AANN incorporates innovation in education. A key objective is to explore the global market to provide education in neuroscience nursing. Alternatives and innovation for neuroscience nurses will be explored on a consistent basis

DISCUSSION What educational tools or opportunities would be most valuable to advancing your clinical and professional practice? What types of evidenced-based education or programs would meet your needs?

Key Message #3 Nurses should be full partners, with physicians and other healthcare professionals, in redesigning U.S. healthcare The third key message calls for nurses to partner with physicians and healthcare providers to redesign US healthcare. To achieve this goal nurses must shift their views in patient responsibilities and relationships with other team members. The World Health Organization has identified the need for team members to collaborate to deliver effective healthcare.

Key Message #3 What does this mean for AANN members? We need to be able to collaborate with other disciplines to redesign neuroscience healthcare We need to develop leadership skills to be able to move fluently from the “bedside to the boardroom” We need to be able to engage with strategic partners and coalitions to shape the way we care for patients In this new healthcare model. As stated in key message number 2, we need to have advanced educational preparation and skills so that we can collaborate with other disciplines as team members, leaders, and patient advocates.

Key Message #3 How can AANN accomplish this? Provide educational opportunities for leadership development across all levels (public, private, governmental) Support the development and dissemination of beginner through advanced leadership competencies Support the development and dissemination of nursing leadership training programs Colleges/universities, organizational Support educational programming within our own organization to develop leaders

Key Message #3 How can AANN accomplish this? Facilitate fellowship/mentor programs for nursing leaders across all levels Mentorships within industry, healthcare organizations, universities, government Provide avenues in available fellowship opportunities (quality, research, access, value of healthcare) Explore fellowship opportunities with our strategic partners

Key Message #3 How can AANN accomplish this? Provide opportunities to lead within our own organization for all members Improve our networking opportunities and options Support our existing leaders, and mentor our new leaders Increase opportunities to volunteer at both the regional and national level Develop a program for leadership development at our annual conference

DISCUSSION What type of leadership training would meet your clinical needs? What type of leadership training would meet your professional needs? What are some of the barriers to volunteering for positions, and how can we remove those barriers?

Key Message #4 Effective workforce planning and policy making require better data collection and an improved information infrastructure

Key Message #4 What does this mean for AANN members? We need workforce capacity data to develop new models of care for the future We need to increase our partnerships and coalitions at a national level to invest in information systems, data collection, data mining, and to influence decisions makers on health policy

Key Message #4 Subcategories Effective Planning Policy Making The AANN strategic plan has identified the goal to “influence the advancement of the field of neurosciences” The AANN Board of Directors recognizes the need to engage in discussions with multiple stakeholders to monitor health policy issues and align with other organizations to obtain the necessary data Data regarding the healthcare workforce must be accurately collected and analyzed Workforce data is key for development of projection models regarding the workforce needs that will be instrumental to the transformation of nursing practice and education Required is a “granularP data set of the current workforce and projections for future workforce needs. Building an infrastructure for the collection and analysis of workforce data, including accurate predictions of future needs, is critical for transformed health care. Policy makers must have reliable, sufficiently granular data on workforce supply and demand, both present and future, across the health professions. Data is required by policy makers to determine what changes are needed in nursing practice and education to advance the vision for health care.

Key Message #4 Effective Planning How can AANN accomplish this? Invest in information systems and technology AANN is an organizational affiliate of ANA Conduct thoughtful data collection and data mining for data driven decision making Develop partnerships and coalitions at the national level to more effectively plan for the subspecialty of neuroscience nursing For instance, be aware if your state is collecting nursing workforce data. If not, advocate for it. For information http://nursingworkforcecenters.org/WorkForceCenters.aspx As an organizational affiliate of ANA, AANN provides data regarding our organization to ANA.

Key Message #4 Effective Planning How can AANN accomplish this? Engage the membership in the planning and implementation processes Review and update the organizational strategic plan in light of landmark reports. Engage in discussions with a variety of stakeholders regarding effective planning

Key Message #4 Policy Making How can AANN accomplish this? Establish relationships with mission similar organizations and identify the primary purpose of these relationships Establish the organizational role in advocacy. AANN Advocacy Statement Standing Advocacy Committee Charge is to develop policies, procedures, and criteria for the organizational role in advocacy Recognize and prioritize needs and engage in select political actions Understand and disseminate how health policy and related changes affect the organization (governances and membership). The development of the advocacy committee is precursor to establishing partnerships and coalitions at the national level, generating opportunities to invest in information infrastructure and workforce planning as well as improve AANN’s ability to monitor the impact on health policy at the BOD and membership levels to influence decision makers.

Key Message #4 Policy Making How can AANN accomplish this? Create a strategic communication plan in order to influence decision makers. Develop partnerships and coalitions at the national level to gain influence for the neuroscience nursing subspecialty. Monitor healthcare policies and issues related to healthcare reform. Assess the actual or potential transformative effect of policies on neuroscience nursing practice and the organization overall.

DISCUSSION Who do you see as your key stakeholders in monitoring health policy? How do you get your information regarding health policy and changes?

CONCLUSION AANN has adopted the 4 key messages of the IOM Future of Nursing Report into the strategic plan of the organization. AANN has created a white paper specific to the needs for neuroscience nurses to provide a blueprint to lead change and advance health AANN is committed to educating its membership on the goals of the Future of Nursing White Paper to ensure successful implementation within the neuroscience nursing community

Thank you to the IOM Task Force for their work in creating this PowerPoint presentation tool. Cindy Sullivan- Chair Andrea Strayer Sandi Brettler Sharon Druce Suzy Walter Nicole Sunderland