1. The Future of Nursing Report Implications for Iowa
Ann Williamson, PhD, RN, NEA-BC
Associate VP for Nursing & Chief Nursing Officer
Rita Frantz, PhD, RN, FAAN
Dean, College of Nursing
April 21, 2011

2. The Report
Commissioned by the Robert Wood Johnson (RWJ) Foundation’s initiative on the future of nursing at the Institute of Medicine
Released in hard copy January 2011

3. The Commission
18 members (5 intergenerational nurses) with expertise in:
Public health
Nursing
Federal & state administration
Hospital & health plan administration
Business administration
Health information & technology
Health services research
Health policy
Workforce research & policy
Economics
Health care consumer perspective

4. Background and Context
The committee was tasked with producing a report that was:
an action-oriented blueprint for the future of nursing
including changes needed in public and institutional policies at the national, state, and local levels
Study process
5 committee meetings
3 public workshops
3 public forums
Literature review
5 commissioned papers
RWJF Nursing research network
Interviews with nurses for case studies and nurse profiles

5. Background and Context
With more than 3 million members, the nursing profession is the largest segment of the nation’s health care workforce.
Working on the front lines of patient care, nurses can play a vital role in helping realize the objectives set forth in the Affordable Care Act.
Legislation enacted will provide insurance coverage to health care for 32 million more Americans; the implications of this new demand on the nation’s health care system are significant.

6. Vision
The committee envisioned a future system that makes quality care accessible to the diverse populations of the United States, intentionally promotes wellness and disease prevention, reliably improves health outcomes, and provides compassionate care across the lifespan.
In this envisioned future, primary care and prevention are central drivers of the health care system.

7. Vision

8. Inter-professional collaboration and coordination are the norm.
Vision
Inter-professional collaboration and coordination are the norm.
Payment for health care services rewards value, not volume of services, and quality care is provided at a price that is affordable for both individuals and society.
The rate of growth of health care expenditures slows.
In all these areas, the health care system consistently demonstrates that it is responsive to individuals’ needs and desires through the delivery of truly patient- centered care.

9. Nurse’s Role in this Vision
Nurses are at the front lines in ensuring that care is delivered safely, effectively, and compassionately.
Because of their regular, close proximity to patients and their scientific understanding of care processes, nurses have a considerable opportunity to act as full partners with other health professionals and to lead in the improvement and redesign of the health care system and its practice environment.
Nurses across the continuum of care have made significant contributions to improving the health of our nation...
…We can do more!

10. Key Messages Recommendations
The Report
Key Messages
Recommendations

11. Key Message #1

12. Key Message #1

13. Key Message #2

14. Key Message #2

15. Key Message #2

16. Key Message #2

17. Key Message #3

18. Key Message #3

19. Key Message #4

20. Implementation Strategy
Regional Access Coalitions
Must be co-led
Five lead states named, but more to follow and not to deter other actions from moving ahead:

21. Implementation Strategy

22. Education of Nurses in Iowa
UIHC Demographics Compared to
Magnet Hospitals and AMCs
Education of Nurses in Iowa
2008
2010
UIHC
Magnet
Academic
Mean Age 43 42
% Female
92%
93%
91%
% White
97%
96%
79%
84%
71% BS
53%
54%
50%
51%
55%
52%
MS/PhD 4% 6% 5% 7%
Certification
16%
17%
24%
21%
22%

23. Nurse Residency We participate in:
The University HealthSystem Consortium (UHC) and American Association of Colleges of Nursing (AACN) Nurse Residency program.
Developed by representatives of the nation's leading academic medical centers and their affiliated schools of nursing, is a one year post-baccalaureate program designed to ease the transition to practice for new graduate nurses.
In the first 3 years, UHC/AACN Nurse Residency Program™ hospitals experienced an aggregate turnover rate of only 5.6%, compared to the national average of 27.1%.

24. Future of Nursing
To ensure the delivery of safe, patient-centered care across settings, an improved nursing education system is critical.
To respond to changing patient needs and an evolving health care systems, nurses must achieve higher levels of education and training.
Education should include opportunities for seamless transition into higher degree programs. 24

25. Education of Nurses in Iowa
Educational Level*
BSN
25% in Iowa
50% nationally
Masters in Nursing
4.3%
Doctoral Degree
0.6%
* IBON,

26. Education of Nurses in Iowa
New Graduates*
BSN = 31%
ADN = 69%
RN to BSN†
21% (nationally)
* IBON,
† HRSA, 2006

27. Strategies to Achieve Goal
Seamless transition to advancing education of RNs
Partnerships between community colleges and 4-year colleges/universities to share standard, competency-based curriculum for BSN
Curricular models for BSN to doctorate to enhance efficiency of graduate preparation
Increased access to education through distance technologies & simulation
Build the case for advanced education among RNs
Transformed roles for nurses in 21st century
Increased complexity of patients
Broader range of competencies required for practice

28. Build partnerships with key stakeholders
Action Steps at Iowa
Build partnerships with key stakeholders
Nurse educators across all program levels
Build collaborative programs
Schools of nursing & practice partners
Create dedicated education units
Experienced clinicians become clinical instructors
Focus on competencies rather than subspecialties
Build the case with consumers
Media campaign focused on outcomes for patients

29. Health Care Transformed
21st Century = “new world” in health care
Unparalleled opportunity for nursing to play strategic role in designing & implementing a more effective & efficient health care system
Time is NOW to innovate, change, transform nursing

30. Questions to ponder – strategies to imagine:
What are the barriers/impediments to progression from RN to BSN?
What are the difficulties that you see new graduates have in transition into practice?
What are the impediments that RNs have to being full-partners in health care at UI?

31. Questions? Other alternatives?