The Kansas Action Coalition:
Creating a Culture of Health for Kansans
Jill Peltzer, PhD, APRN-CNS, Qiuhua Shen, PhD, APRN,
Debra Ford, PhD, & Cynthia Teel, PhD, FAAN, RN
University of Kansas School of Nursing
Session Objectives
• Describe the Future of Nursing report’s key messages
and eight recommendations.
• Examine the Kansas Action Coalition.
• Describe the Kansas nursing workforce.
• Explain the Kansas Action Coalition projects.
• Explore opportunities to create a culture of health in
Kansas.
Campaign Vision –
That all Americans have access
to high-quality, patient-centered
care in a health care system
where nurses contribute as
essential partners in achieving
success.
Transforming health care through
nursing
8 recommendations of FoN report
1. Remove scope of practice
barriers
5. Double the number of nurses
with a doctorate by 2020
2. Expand opportunities for nurses 6. Ensure that nurses engage in
to lead & diffuse collaborative
lifelong learning
improvement efforts
3. Implement nurse residency
programs
4. Increase the proportion of
nurses with a BSN to 80% by
2020
7. Prepare and enable nurses to
lead change to advance
health
8. Build an infrastructure for
collection & analysis of
interprofessional health care
workforce data
http://campaignforaction.org/sites/default/files/2015-Dashboard-Final-5.27.15.pdf
Campaign supporters
Hospitals and
health systems
Philanthropies
Educators
Payers
Health professionals
Business
Public health agencies
Consumer advocates
State Action Coalitions
Policy-makers
KSAC promotion video
Kansas action steps
Practice
Education
Leadership
Advocacy
Working to full extent of
Practice for RNs as well
as APRNs
Development of
standardized
prerequisites
Based upon a needs
assessment through the
Leadership and
Mentorship Survey work
has begun to develop:
Advance the health of
Kansans by
championing
nursing’s capacity to
transform health and
healthcare
•
•
Develop and sustain
grassroots campaign
for support of the
changes to the KS
Nurse Practice Act
Develop and deliver
an educational
module to focus on
what full scope of
authority looks like
for all nurses
•
•
Discuss and develop
model for statewide
academic
progression
Encourage lifelong
learning- create
webinar focused on
importance of
continuing
education
throughout the
lifetime
Interprofessional Collaboration
•
•
•
•
Leadership
Resources
Mentorship Program
Online Platform to
create “Match.com”
style website to
match mentors with
mentees
Webinar series to
help prepare nurses
to serve on boards
Diversity
•
•
•
Build capacity for
advocacy; how to
advocate for
KSAC
Create an
elevator speech
for nurse
champions
ID outside groups
to connect with
Data
#8 Build an infrastructure to collect & analyze interprofessional health care workforce data
KS Action Coalition Partners
NURSE PARTNERS
NURSE CHAMPIONS
University of Kansas
University of Kansas Hospital
Pittsburg State University
Kansas Dept of Commerce
Fort Hays State University
Kansas Dept of Health & Environment
Wichita State University
Kansas Dept of Labor
Washburn University
REACH Healthcare Foundation
KACN - Kansas Association of Colleges of Nursing
Health Care Foundation of GKC
KCADNE- Kansas Council of Associate Degree Nurse Educators Robert Wood Johnson Foundation
KCPNE- Kansas Council of Practical Nursing Educators
Kansas Organization of Nurse Leaders
Kansas State Nurses Association
Kansas State Board of Nursing
KCCN – Kansas Council for Collaboration in Nursing
AARP, Inc.
KSAC
Data Collection Efforts
Completed and ongoing studies
1.
2.
3.
4.
RN Workforce Survey
Leadership & Mentor Survey
RN-BSN Program Survey
Cultural Competency Survey
a. Individual nurses
b. Pre-licensure & RN-BSN program curricula
5. KS Faculty Retirement Survey (new)
Kansas RN workforce survey
• Survey Development
• Promoting Nursing Education in Kansas (PNEK)
• KSBN, KS Department of Labor, & KansasWORKS
• Survey Distribution
• 11/2013 – 01/2014
• Online survey link was sent to 44,568 RNs
• KS Nursing Newsletter ad; KC Nursing News article
• Survey Response
• n = 6,948
• 15.6% response rate
Survey sample represents KS RN
population
Kansas RN Workforce
Survey Sample
Gender
Age
Race
92 % Female
31%
53%
16%
< 40 yrs
41-60 yrs
> 61 yrs
92% White
2012 Kansas
RN Population
92 % Female
36%
48%
16%
< 40 yrs
41-60 yrs
> 61 yrs
89% White
Who we are
• 80% are actively employed in position requiring a
KS RN license
• For those working as RN, 84% are full time
• 82% have only 1 RN position
• > 60% licensed before year of 2000
• ~ 50% have worked in current RN position > 5 years
• 7.5% (n = 440) plan to retire in next 2 years
Work setting, Clinical area, & Role
Work Setting
• 48% work in hospital
• 16% work in ambulatory care
• 8% in academics
Clinical Area (for the ~4,800 in direct care)
• 13% med/surg
• 11% ambulatory care
• 8% pediatrics
• 6% intensive/critical care
Nursing Role
• 49% work in staff nurse role
• 11% work in nurse manager role
Number of Registered Nurses
Education level at initial licensure = 46.3% BSN
Current education level = 60.5% BSN
4500
4029
4000
3500
3035
3000
2594
2500
2039
2000
46.3%
1500
1000
500
Initial Nursing
Education (n = 6552)
60.5%
39.6% 30.6%
923
589
14.1% 8.8 %
0
Diploma
Associate
Nursing Education Levels
BSN or
Higher
Current Nursing
Education (n = 6657)
Current nursing education levels among KS
RNs were comparable to the national level
61%
BSN or Higher
60%
28%
Associate
Diploma
31%
11%
9%
0% 10% 20% 30% 40% 50% 60% 70% 80%
National RNs*
Kansas RNs
*Based on Results from
2013 National Workforce
Survey of RNs by the
National Council of State
Boards of Nursing and the
Forum of State Nursing
Workforce Centers
Comparisons with other states…
KS
MO1,2
NE3
IA4
NM5
OK6
TX7
National8
Demographics
Age, in years
47.7
47.0
44.0
-
49
-
46
50
20-39 years
40-59 years
≥ 60 years
Gender
Female
Male
Race/Ethnicity
White/Caucasian
Minority
29%
52%
19%
35%
45%
20%
42%
45%
13%
34%
46%
20%
30%
52%
17%
-
32.3%
51.0%
16.7%
-
92.1%
7.9%
-
94.4%
5.6%
94.8%
5.2%
-
91.1%
8.9%
88.3%
11.7%
93%
7%
91.9%
8.1%
90%
10%
-
57%
43%
-
63.0%
37.0%
83%
17%
14.1%
36.6%
46.3%
-
17.8%
28.5%
53.7%
16%
55%
29%
14.5%
50.4%
35.1%
-
10.8%
49.0%
40.2%
23%
39%
38%
9%
31%
60%
9%
35%
56%
16.0%
25.6%
58.4%
10.5%
44.5%
45.0%
-
7.9%
42.6%
49.5%
7.0%
40.8%
52.2%
11%
28%
61%
Initial Nursing Education
Diploma
ADN
BSN or higher
Current Nursing Education
Diploma
ADN
BSN or higher
94.4%
5.6%
Education
Comparisons with other states…
KS
MO1,2
NE3
IA4
NM5
OK6
TX7
National8
77%
9.6%
13.2%
-
60%
10%
27%
3%
66.6%
8.2%
22.8%
2.4%
54%
30%
12%
4%
Licensing
APRN Licensing
Nurse Practitioner
Clinical Nurse Specialist
CRNA
Certified Nurse Midwife
Actively Employed in
Nursing
Full-time
Employment Settings
Academic setting
Ambulatory care setting
Community/Public health
Hospital
Nursing home/extended
care/assisted living
facilities
57.7%
21.7%
14.8%
2.6%
72%
6%
21%
1%
68%
74.6%
8%
3.0%
22%
18.5%
2%
3.9%
Employment
90.6%
-
98.7%
91.4%
89.7%
77%
89.4%
82%
84.0%
-
-
77.0%
78.4%
-
87.3%
60%
8%
16%
5.7%
48%
5.7%
2.7%
1.9%
2.1%
59%
4.5%
5.4%
13.9%
6.6%
56.6%
10.5%
21%
59%
6%
2.2%
12.5%
2.9%
54.4%
3.9%
2.8%
5.5%
4.2%
61.7%
4.9%
1.6%
7.3%
1.9%
65.5%
3.0%
3%
9%
4%
56%
6%
Note: KS, Kansas; MO, Missouri; NE, Nebraska; IA, Iowa; NM, New Mexico; OK, Oklahoma; TX, Texas; ADN, Associate Degree in Nursing; BSN, Bachelor of Science in Nursing; CRNA, Certified Registered Nurse Anesthetist. .
1. Data were retrieved from Missouri State Board of Nursing 2014 Annual Report. http://pr.mo.gov/boards/nursing/publications/annual/2014-Annual%20Report.pdf
2. Data were retrieved from Missouri Department of Health and Senior Services, Missouri’s Nursing Workforce 2014: http://www.mocenterfornursing.org/Documents/MissourisNursingWorkforce2014.pdf & http://www.mocenterfornursing.org/WorkforceData.aspx
3. Data were retrieved from Nebraska Center for Nursing, Nebraska RN Survey Report 2013. http://www.center4nursing.com/documents/RNWorkforceSurveyReport2012_JPR_29Jan2014.pdf
4. Data were retrieved from Iowa State Board of Nursing 2014 Annual Report. http://nursing.iowa.gov/images/pdf/Annual%20Report%202014.pdf
5. Data were retrieved from 2013 Annual Report New Mexico Health Workforce Committee: http://www.nmnec.org/uploads/FileLinks/933875ef41ef4474b4e844f09423bbef/2013_Annual_Report_New_Mexico_Health_Workforce_Committee.pdf
6. Data were retrieved from Oklahoma State Board of Nursing 2014 Annual Report. http://www.ok.gov/nursing/anrep14.pdf
7. Data were retrieved from Texas Department of State Health Service: http://www.dshs.state.tx.us/chs/cnws/2013-Demographics-and-Trends-Report.pdf
8. Data were retrieved from Budden, J.S., Zhong, E.H., Moulton, P., & Cimiotti, J.P. (2013). Highlights of the national workforce survey of registered nurses. Journal of Nursing Regulation,4 (2), 5-14
- data were not available to retrieved.
Kansas RN-BSN Program survey
• Purpose
• describe the characteristics of current
students enrolled in the RN-BSN programs
in Kansas
• Survey sent to all RN-BSN programs in KS
with 100% response rate each year
• 2013 11 programs
• 2014 11 programs
• 2015 12 programs
Kansas RN-BSN Programs survey
1400
1200
1000
2013
2014
2015
1275
1203
939
80%
70%
73%
61%
2013
2014
2015
66%
60%
50%
800
600
400
10%
0
0%
90%90%88%
90%
80%
2014
80%
70%
2015
70%
60%
60%
50%
50%
40%
40%
30%
30%
20%
10%10%12%
10%
Female
Male
2013
78%
75%
69%
2014
2015
20%
10%
0%
1% 0% 1%
20 - 40 Years41 - 60 Years > 60 Years
Enrollment
2013
90%
26%
20%
269
Graduates
33%
30%
391 407
200
100%
39%
40%
10% 8%
6%
5%7%6%
3%
3%
1%0%1% 2%
13%
6%
5%
0%
AI/NA
Asian
Black
Hispanic Caucasian
Other
Leadership survey
• Purpose
• Inform workforce needs in formal &
informal leadership roles
• Online 12-item survey through KSAC website
• 971 Kansas RNs completed survey
• Sample from all geographic areas of KS
Leadership roles
• 62% identified current leadership position
• Admin/Mgmt: Academics and practice
• Educator: Academics and practice
• Committee: Academics, practice, and
community
• Professional Association
• Boards
• Mentor/Advisor/Preceptor
Leadership goals
Desired Leadership Positions
n
Healthcare organization volunteer
206
Administrative leadership
190
Community organization
171
Hospital or other governance board
146
Elected position in professional nursing organization
144
Shared governance position
98
Elected position at any level
51
School board system
47
What prevents leadership
development?
Barriers
n
Lack of time during work for participation as a leader
339
Lack of time outside work for participation as a leader
327
Would like more leadership development before serving
157
Lack of supervisor support to participate in leadership roles
137
Lack of colleague support to participate in leadership roles
128
Leadership service not recognized by my organization
109
Conflict of interest between organizations
57
Leadership development needs
Professional Development Programs
n
Personal Leadership Skill Development
318
Understanding How to Influence Policy
309
Networking Skill Development
249
Understanding Budget and Finance
250
Communication Skill Development
231
Skill Development for HCO Board
199
Other
40
62% interested in Boardroom-focused leadership training
Cultural Competency study
Purpose
• Evaluate nurses’ knowledge, skills, and attitudes of cultural
competency according to 2014 Culturally Competent
Nursing Care guideline
• Assess pre-licensure and RN-BSN programs’ curricular
content on cultural competency using 2014 Culturally
Competent Nursing Care guideline
• Data collected April-June 2015.
• 171 nurses from across Kansas participated in the
survey
• 34 pre-licensure nursing programs and 4 RN-BSN
nursing programs completed survey (62% response
rate).
2014 Culturally Competent Nursing Care guidelines
1
2
3
4
5
6
7
8
9
10
Knowledge of Cultures: Nurses shall gain an understanding of the perspectives, traditions, values, practices,
and family systems of the culturally diverse populations for whom they provide care, as well as knowledge of
the complex variables that affect their achievement of health and well-being.
Education and Training in Culturally Competent Care: Nurses shall be educationally prepared to provide
culturally congruent health care.
Critical Reflection: Nurses shall engage in critical reflection of their own values, beliefs, and cultural heritage
in order to have an awareness of how these qualities and issues can influence culturally congruent nursing
care.
Cross-Cultural Communication: Nurses shall use culturally competent verbal and nonverbal communication
skills to identify client’s values, beliefs, practices, perceptions, and unique health care needs.
Culturally Competent Practice: Nurses shall use cross-cultural knowledge and culturally sensitive skills in
implementing culturally congruent nursing care.
Cultural Competence in Health Care Systems and Organizations: Health care organizations should provide the
structure and resources necessary to evaluate and meet the cultural and language needs of their diverse
clients.
Patient Advocacy and Empowerment: Nurses shall recognize the effect of health care policies, delivery
systems, and resources on their patient populations and shall empower and advocate for their patients as
indicated.
Multicultural Workforce: Nurses shall actively engage in the effort to ensure a multicultural workforce in
health care settings. One measure to achieve a multicultural workforce is through strengthening of
recruitment and retention efforts in the hospitals, clinics, and academic settings.
Cross-Cultural Leadership: Nurses shall have the ability to influence individuals, groups, and systems to
achieve positive outcomes of culturally competent nursing care for diverse and vulnerable populations.
Evidence-Based Practice and Research: Nurses shall base their practice on interventions that have been
systematically tested and shown to be the most effective for the culturally diverse populations that they
serve.
Nurses’ knowledge, skills, & attitudes
• > 70% were Knowledgeable or Very
knowledgeable about the 2014 guidelines
• > 60% felt Competent or Very Competent in
their skills in using the 2014 guidelines
• > 80% thought the 2014 guidelines were
Important or Very Important.
Integration of culturally competent
content into curricula
Guidelines focusing on the individual’s cultural
competency (i.e., Guidelines 1-5) typically were
reported as being integrated “A little” or “Quite a bit”
into the program curricula (83% - 100%)
More systems-focused guidelines (i.e., Guidelines 610) were less likely to be integrated into the
curricula, especially Guideline #9 (cross-cultural
leadership)
KSAC Products
Resources for academic progression
Mentoring program
KSAC 2015 Summer Summit
Creating a Culture of Health in Kansas:
Advancing Nursing Education and Leadership
Northeast Region
Northwest Region
Acute
Care
Acute
Care
School
Hays
School
LongTerm
Care
Final Meeting Location
Topeka, KS
Southeast Region
Acute
Care
School
Wichita
LongTerm
Care
Public
Health
Public
Health
Southwest Region
Kansas
City
Acute
Care
LongTerm
Care
School
Pittsburg
Public
Health
Public
Health
LongTerm
Care
Diversity in Nursing
Key issue: increase nursing workforce diversity
• US minority populations currently = 37%
• Expected to = 50% by 2060
• Kansas minority populations = 23%
• Currently, US nursing workforce
• 83% White and 93% female
• In KS, even less diversity in nursing
• 93% White and 93% females
Creating a culture of Health in
Kansas
What can we do in our communities to
build a culture of health?
Call to Action
• Education Team
• Seamless academic progression
• Practice Team
• Full scope of practice
• Leadership Team
• Leadership development
• Advocacy Team
• Advocacy/policy
development
More Information
Visit us on the Web
http://www.kansasactioncoalition.com
http://campaignforaction.org/
Follow us on twitter
www.twitter.com/kansasac
https://twitter.com/Campaign4Action
http://twitter.com/championnursing
Join us on Facebook
www.facebook.com/kansasac
https://www.facebook.com/futureofnursing#!/CampaignForAction
http://www.facebook.com/championnursing
Join us!
Send inquiring e-mail to:
Jon Teel jteel@kumc.edu
Catch us on Facebook & Twitter
http://facebook.com/kansasac
https://twitter.com/#!/KansasAC