Nebraska Hospital Association
May 15, 2013
Linda Lazure
Rosanna Morris
Marilyn Valerio
Victoria Vinton
Institute of Medicine Report
Committee Charge: To examine the
capacity of the nursing workforce
to meet the demands of a reformed
health care and public health
system
IOM Recommendations:
A Blue Print for Action
• Recommendation 1: Remove scope-of-practice
barriers. Advanced practice registered nurses
should be able to practice to the full extent of
their education and training.
• Recommendation 2: Expand opportunities for
nurses to lead and diffuse collaborative
improvement efforts.
• Recommendation 3: Implement nurse residency
programs.
• Recommendation 4: Increase the proportion of
nurses with a baccalaureate degree to 80 percent
by 2020.
IOM Recommendations (cont.)
• Recommendation 5: Double the number of
nurses with a doctorate by 2020
• Recommendation 6: Ensure that nurses engage
in lifelong learning
• Recommendation 7: Prepare and enable nurses
to lead change to advance health.
• Recommendation 8: Build an infrastructure for
the collection and analysis of interprofessional
health care workforce data.
•
Action Coalitions (ACs) are the driving force of the Future of Nursing:
Campaign for Action (CFA), national effort to implement the Institute of
Medicine’s (IOM) recommendations.
•
The Campaign is a collaboration created by the Robert Wood Johnson
Foundation (RWJF) and the AARP Foundation.
•
The Campaign is building action at the local, state, and regional levels, to
support a transformed health care workforce in which nurses contribute
as essential partners in system-wide transformation.
•
ACs will capture best practices, determine research needs, track lessons
learned and identify replicable models. With assistance from the Center
to Champion Nursing in America (CCNA) and RWJF, RACs are developing
and implementing unique sets of regional goals and campaigns within the
framework of the IOM recommendations.
Advancing Education
Transformation
Removing Barriers to
Practice and Care
Nursing Leadership
INTERPROFESSIONAL COLLABORATION
DIVERSITY
DATA
Nebraska
Action
Coalition
Leading Change,
Advancing Health
Visiting Nurse Association, Lead Nurse Partner
HDR Architecture, Inc., Lead Non-Nurse Partner
NAC Formation
• Steering Committee formed November 2010
• Identified lead partners: VNA/HDR
• Formal application submitted to the RWJF/
AARP to become a Regional Action Coalition
• Solicited up to $90,000.00 in funding
• Hired Director to coordinate & facilitate
action plans
Nebraska Action Coalition
Executive Committee (1)
J. Summerfelt, B. Cernech,
C. McCullough, L. Lazure, M. Cramer,
M. Valerio, R. Morris, J. Lazure,
N. Gondringer, D. Kozeny, A. Orduna,
L. Walline, D. Straub
Non-Nursing Organization Lead
(4)
HDR Architecture, Inc.
NAC Director (2)
V.Vinton (1FTE)
Nursing Organization Lead (5)
Visiting Nurse Association
Strategic Advisory Committee
(3)
D. Frey MD VP Creighton Health
Sciences; C. Benjamin AARP-NE;
P. Lopez MSN, PHAN; K. Moore
MSN-RWJF Fellow CEO St. Elizabeth
Hosp,
J. Ulrich CEO Community HospMcCook
Advancing Nursing Education Statewide
Team (6)
M. Valerio & A. Orduna, Co-Leads
L. Connelly & K. Weidner, North Co-Chairs
S. Hayek, S. Pitkin, C. Quadhamer, South
V. Hess & T. Delahoyde, East Co-Chairs
S. Wilhelm & M. Thomas, West Co-Chairs
Advancing Nursing Leadership Statewide
Team (7)
L. Walline & D. Straub Co-Leads
S. Fleming & T. Brown, North Co-Chair
C. Wahl & M. Wolf, South Co-Chair
P. Agee-.Lowrey, D.Ernesti, M.Paradis East
West Co-Chair (need 2)
Consultant: R. Morris
Diversity
Interprofessional Collaboration
DATA
See NAC Organizational Chart
Description (1-8)
Financial Support Staff part of in-kind
from VNA
Advancing Nursing Practice Statewide
Team (8)
N. Gondringer & D. Kozeny Co-Leads
North Chair (need 2)
S.Borden, South Chair (need 1)
T. Spohn, and T, Baker, East Chair
R. Bowman & M.Zimmerman West Chairs
Acute Care Consultant: J. Lazure
Legislative Consultant: L. Lazure
NAC Strategic Focus
•
•
•
•
•
Preparation of nurses for the future
Manage Care Transitions
Improve access to care
Improve patient outcomes
Operationalize interdisciplinary team
approach to care
Formed three state-wide teams using IOM
framework to develop tactics to achieve
outcomes: Education, Practice, and Leadership
Advancing Education
Prepare nurses to meet new
challenges in health & health care.
• Increase the proportion of nurses with BSN
and higher degrees.
• Increase the number of nurses with
doctorates.
• Implement nurse residency programs.
1.Define academic pathways,
promote seamless access for
nurses to higher education.
2.Enable ADN and diploma RNs
to obtain BSN by removing
barriers.
3.Encourage health care
organizations to identify and
support incentives for advancing
education.
IOM Action Steps

Data collected from all 20
Nebraska schools of nursing in
collaboration with NANDD.

Developing competency –based
approach for seamless articulation
– pilot fall 2013

SIP Grant awarded for $150K –
focuses on seamless articulation,
leadership development, &
diversity.
NAC Update….
Advancing Education
Education
Evidence
Studies show association between higher
nurse education level and improved health
care outcomes.
• Evidence that higher proportions of BSN-prepared nurses
associated with lower rates of medication errors, mortality,
and failure to rescue.
• Research also shows that BSN-prepared nurses have
stronger diagnostic skills and are better at evaluating
interventions.
• A growing body of research shows a connection between
baccalaureate education and lower mortality rates.
Advancing Nursing Practice
• Enhance access to care through use of RNs,
APRNs in primary, chronic & transitional
care
• Utilize nurses to practice to full education
& training
• Redesign the role of nursing specific to care
coordination
Advancing Leadership
• Build a diverse workforce to better reflect
population served
• Utilize nurses in education and leadership to
participate in healthcare redesign
• Prepare and enable nurses to lead change
• Coach and mentor nurses at all levels
• Prepare nurses to be active decision makers
Contributors
•
Visiting Nurses Association
•
Nebraska Nurses Association
•
HDR Architecture, Inc.
•
Nebraska Nurse Midwives
•
Immanuel Communities
•
Nebraska Nurse Practitioners
•
Saint Elizabeth Regional Medical Center
•
NONL
•
Nebraska Medical Center
•
Community Hospital - McCook
•
Alegent Health
•
Methodist Hospital
•
Great Plains Med Center – North Platte
•
AWHONN
•
Good Samaritan Hospital – Kearney
•
NNA District 2
•
St. Francis Med Center – Grand Island
•
Nebraska Methodist College
•
Executive Committee of NAC
•
Clarkson College
•
NE Assembly of Nursing Deans & Directors
•
AARP-Nebraska Chapter
•
Creighton University School of Nursing
•
Equitable Bank Foundation –Grand Island
•
University of Nebraska College of Nursing
•
Five Points State Bank – Grand Island
•
Donor-members of NAC
•
Heartland Gerontological Nurse Association
•
Nebraska Association of Nurse Anesthetists
•
NE School Nurse Association
•
Nebraska Emergency Nurses Association
•
NE American Psychiatric Nurse Association
The NAC- Future of Nursing
Requests your Support
Endorsement
– Partner with you and others to redesign
healthcare in the state of Nebraska
– Focus on access to care
– Facilitate Care Transitions
– Improve patient outcomes & the health of the
public
Financial Support
http://www.neactioncoalition.org
Please join us in this important
work!
For more information, contact:
Victoria Vinton, MSN, RN
Director, Nebraska Action Coalition
Call: 402-830-7769
Email: vvinton@neactioncoalition.org
References
Aiken, L. et al., (2011). Effects of nurse staffing and nurse education on
patient deaths in hospitals with different nurse work
environments. Medical Care 49: 1047-53.
Benner, P. et al. 2010. Educating Nurses: A Call for Radical
Transformation. Jossey-Bass.
Blegen, M., Good, C., Park, S., Vaughn, T., & Spetz, J. (2013).
Baccalaureate Education in Nursing and Patient Outcomes.
Journal of Nursing Administration, 43(2): 89-94.
Chen, L., Nguyen, A., Shaw-Sutherland, K. The Economic Impact of the
Health Care Sector on Nebraska’s Economy, 2009. UNMC NE
Center for Rural Health Research & NE Office of Rural Health,
March, 2012.
Cramer, M., Jones, K. J.(2011). Nurse Staffing in Critical Access Hospitals.
Journal of Nursing Quality Care,
DOI:10.1097/NCQ.0b013e318219d30a.
IOM (Institute of Medicine). 2011 The Future of Nursing: Leading Change,
Advancing Health. Washington D.C. The National Academies
Press.
References
Kutney-Lee, A., Sloane, D., & Aiken, L. H. An Increase in the Number of
Nurses with Baccalaureate Degrees is Linked to Lower Rates of
Postsurgery Mortality. Health Affairs. 2013; 32 (3): 579-586.
Joynt, K., Orav, E.J., & Jha, A. Mortality Rates for Medicare Beneficiaries
Admitted to Critical Access and Non-Critical Access Hospitals, 20022010. JAMA. 2013; 309(13):1379-1387.
Newhouse, R.P., et al. A Phased Cluster-randomized Trial of Rural
Hospitals Testing a Quality Collaborative to Improve Heart Failure
Care: Organizational Context Matters. (2013). Medical Care, 51(5): 396403.
Pew Research Center The Data Bank, retrieved September 3
http://pewresearch.org/pubs/1834/baby-boomers-old-age-downbeatpessimism