Transcription
The Future of Nursing:Implications for ProfessionalOrganizations and CertifiersJoanne V. Hickey, PhD, RN,APRN, ACNP-BC, FCCM, FAANPatricia L. Starck/PARTNERS Professor of NursingUniversity of Texas Health Science Center at Houston
The Future of NursingImperatives for quality and safety Unprecedented times in health caredelivery, practice, education, andregulation Transformation, crisis, and opportunity Significant moment - a limited windowof time Victims or drivers of change
Changing Landscape IOM Health Professions Education: ABridge to Quality (2003) Carnegie Report Educating Nurses: A Callfor Radical Transformation (2009) Macy/IOM Redesigning ContinuingEducation in the Health Professions(2010) RWJF/IOM Future of Nursing: LeadingChange, Advancing Health (2010)
The Future of Nursing: Leading Change, AdvancingHealth (2010)Carnegie ReportEducating Nurses: ACall for RadicalTransformation(2009)Macy/IOM RedesigningContinuing Educationin the HealthProfessions (2010)Health Professions Education: A Bridge to Quality (2003)
Health Professions Education:A Bridge to Quality (2003)Institute of Medicine report Doctors, nurses, pharmacists andother health professionals are notbeing adequately prepared to providethe highest quality and safest medicalcare possible, and there isinsufficient assessment of theirongoing proficiency.
Health Professions Education:A Bridge to Quality (2003) Educators and accreditation, licensing andcertification organizations should ensurethat students and working professionalsdevelop and maintain proficiency in fivecore areas: delivering patient-centered care, working as part of interdisciplinary teams, practicing evidence-based medicine, focusing on quality improvement, and using information technology.
Carnegie Report Educating Nurses: ACall for Radical Transformation (2009)More education is not enough; needhigher quality of education radicallydifferent from current norms US programs not effective in teachingnursing science, natural sciences,social science, technology, andhumanities Refocus from critical thinking toclinical reasoning
Macy/IOM Redesigning ContinuingEducation in the Health Professions(2010) Major flaws in ways CE conducted, financed,regulated, and evaluatedCE science fragmented and underdevelopedCE should bring health professionals fromvarious disciplines togetherA new comprehensive vision of professionaldevelopment neededEstablish a national interprofessional CEInstitute to foster improvements in CE forhealth professionalsFocus on continuous life long learning
Future of Nursing: LeadingChange, Advancing Health (2010)Partnership between RWJF and IOM First IOM study focused only onnursing Interdisciplinary committee members Report based on evidence rather thanconsensus. Different format to recommendations Detail plan for dissemination andengagedment
Opportunity & Vision U.S. has opportunity to transform itsHC system to provide higher quality,safer, more affordable, and moreaccessible care.Vision: a future system that makesquality care accessible to the diversepopulations of the U.S., intentionallypromotes wellness and diseaseprevention, reliably improve healthoutcomes, and provide compassionatecare across the life span.
Major Recommendations1.2.3.4.Nurses should practice to the full extent oftheir education and training.Nurses should achieve higher levels ofeducation and training through an improvededucational system that promotes seamlessacademic progression.Nurses should be full partners, withphysicians and other health professionals, inredesigning health care in the U.S.Effective workforce planning and policymaking require better data collection and animproved information infrastructures.
Approach to RecommendationsTo achieve each goal, the committeerecommended actions to multiple stakeholders: Congress State legislatures Centers for Medicare and Medicaid Services Office of Personnel Management Federal Trade Commission and the AntitrustDivision of the Department of Justice
Major Recommendations #1Nurses should practice to the fullextent of their education and training.Scope of practice issues Support through affiliation with ABNS andother professional organizations Residencies for transition from school towork Support and facilitate across continuumnot just acute care
Major Recommendations #1Create model of transition from school towork including transition into subspecialtyneuroscience practice. Competency based Prepare and disseminate a position paperthat includes transition into subspecialtyneuroscience practice.
Major Recommendations #2Nurses should achieve higher levels ofeducation and training through animproved educational system thatpromotes seamless academicprogression. Education of neuroscience nurses through avariety of educational programs (degree andnon-degree programs/institutes/fellowships) Develop comprehensive set of clinicalperformance competencies (p. 14). Review and revise Neuroscience Scope andStandards
Major Recommendations #2 Foster a culture of lifelong learning. Use a variety of traditional and innovativemethodologies for education (on-line, face-toface, etc.) Support interdisciplinary neuroscience education. Diffusion of successful best practices Adoption of innovative patient care models Entrepreneurial professional developmenteducation that will enable nurses to initiativeprograms and businesses that will contribute toimproved health and health care Opportunity for new products from AANN.
Major Recommendations #3Nurses should be full partners, withphysicians and other healthprofessionals, in redesigning health carein the U.S. Nursing organizations should provide leadershipdevelopment, mentorship programs, andopportunities to lead for all of its members (p. 14) Nurses lack general and specific leadershipcompetencies Leadership from bedside to boardroom. Whatwill it take?
Major Recommendations #3 Create leadership programs for a variety of levelsso that nurses will have the competencies to leadin implementing changes in quality, access, andvalue of health care. Create leadership and mentorship programs. Assist neuroscience nurses in mapping theirprofessional development and careers Facilitate fellowship programs with healthagencies Johnson & Johnson CDC CNOs
Major Recommendations #4Effective workforce planning and policymaking require better data collection and animproved information infrastructures. Investment in information systems andtechnology Data collection and data mining Partnerships and coalitions at national level Engaging membership Political action Understanding impact on health policy at boardand membership level
Major Recommendations #4Review of organizational strategic plan inlight of these major reports Engage is discussion with a variety ofstakeholders Monitor health policy issues
Other Recommendations forABNN and AANN White paper(s) from ABNN/AANN on Future ofNursing report Could be a series of articles on each majorrecommendation in the Journal Could be a series of articles impact on the profession,specialty practice, education, research, certification,health care reform Suggest position paper on impact/relevance ofreports to certifying bodies to ABNS Include a session on “progress made” inachieving recommendations at nextyear’s annual conference.
Other Recommendations forABNN and AANNSystematic reviews on topics ofinterest related to certification anddissemination Agenda item at ABNN meetings todiscuss further implications for ABNNand certification Partnerships with other AANN entitiesto ensure thoughtful change andleadership
Closing ThoughtsGreat opportunities that is time limitedNeed for innovative thinking andengagement is now Review, discuss, and assess impact ofrecommendations needed Once window of opportunity closes,cannot be recaptured The key is leadership nurses must beprepared as leaders at all levels toachieve the best for patients and theprofession.
Future of Nursing: Leading Change, Advancing Health (2010) Partnership between RWJF and IOM First IOM study focused only on nursing Interdisciplinary committee members Report based on evidence rather than consensus. Different format to recommendatio
