Category Archives: Future of Nursing
This is part of the March 2014 issue of Sharing Nursing’s Knowledge.
Comparing Nurse and Physician Performance on Colonoscopies
A new study finds that colonoscopies performed by nurse and physician endoscopy trainees are comparable in terms of quality and safety.
Researchers in The Netherlands studied 15 endoscopy trainees—seven nurses and eight physicians—at two medical centers over the course of three-and-a-half years. At the beginning of the study, none had experience in endoscopy. All were trained according to the applicable regulations of the Dutch Society of Gastroenterology, performing a minimum of 100 colonoscopies. After completing their training, each performed 135 consecutive colonoscopies under the supervision of a gastroenterologist, with their work evaluated for safety and quality.
The nurse group and the physician group had comparable results on both measures, with the nurse group producing marginally better scores in some areas. Each group detected the same percentage of adenomas (benign polyps), and had the same low rate of complications. The nurses had slightly higher rates of cecal intubation (successfully passing the colonoscope to a key part of the colon), and slightly higher rates of completing the procedure without assistance.
Jane Kirschling, PhD, RN, FAAN, is president of the American Association of Colleges of Nursing and an alumna of the Robert Wood Johnson Foundation Executive Nurse Fellows program. This post is part of the “Health Care in 2014” series, in which health leaders, as well as Robert Wood Johnson Foundation scholars, grantees, and alumni, share their New Year’s resolutions for our health care system and their priorities for action this year.
2014 marks the 10th anniversary of the landmark study conducted by Linda Aiken, PhD, FAAN, FRCN, RN, and colleagues, which showed a strong connection between nursing education and patient outcomes. Published in the September 2004 issue of the Journal of the American Medical Association (JAMA), the study’s researchers found that patients experienced significantly lower mortality and failure to rescue rates in hospitals with higher proportions of baccalaureate-prepared nurses. In her analysis, Dr. Aiken stated that the study’s results “suggest that employers’ efforts to recruit and retain baccalaureate-prepared nurses in bedside care and their investments in further education for nurses may lead to substantial improvements in the quality of care.”
A High Priority for Action in 2014
Marsha Howell Adams, PhD, RN, CNE, ANEF, is president of the National League for Nursing (NLN), and senior associate dean of academic programs and professor at The University of Alabama Capstone College of Nursing. This post is part of the “Health Care in 2014” series, in which health leaders, as well as Robert Wood Johnson Foundation scholars, grantees, and alumni, share their New Year’s resolutions for our health care system and their priorities for action this year.
This past December, I was lucky to attend a holiday reception at the White House with Judith Halstead, PhD, RN, FAAN, ANEF, my immediate predecessor as president of the NLN. It’s one of the nice benefits of being president.
I have experienced the White House via public tours many times throughout the years, but this visit was very different. We were able to explore rooms that those on White House tours can only glimpse from the hallways. We could study the art on the walls and absorb a sense of the purpose, power, and passion of past and present leaders. The prospect of meeting the president and first lady created such an excitement in me that it almost took my breath away. No matter one’s political point of view, meeting our nation’s president, especially in the White House, is truly an honor and a privilege.
The federal government announced late last year it would deliver $55.5 million in fiscal 2013 to programs designed to strengthen, diversify, and grow the health care workforce.
The bulk of the funds—82 percent, or $45.4 million—are targeted at nurses, the largest segment of the health care workforce.
The announcement came as welcome news to supporters of a national campaign backed by the Robert Wood Johnson Foundation (RWJF) and AARP that is working to transform the nursing profession to improve health and health care.
Many of the grants support the Future of Nursing: Campaign for Action’s call for a more highly educated and more diverse nursing workforce and for more interprofessional collaboration among nurses and other health care professionals, according to Winifred Quinn, PhD, co-director of the Center to Champion Nursing in America, an initiative of AARP, the AARP Foundation, and RWJF.
Have you signed up to receive Sharing Nursing’s Knowledge? The monthly Robert Wood Johnson Foundation (RWJF) e-newsletter will keep you up to date on the work of the foundation’s nursing programs, and the latest news, research, and trends relating to academic progression, leadership, and other essential nursing issues. These are some of the stories in the December issue:
School nurses play a vital role in improving the health of children and the public, yet students in one-quarter of the nation’s public schools have no access to a school nurse. Still, need is rising as medical advances allow more premature babies and others with severe health conditions to survive. Several RWJF Scholars are working to address this problem, as is the National Association of School Nurses.
Efforts to increase the percentage of baccalaureate-educated nurses in West Virginia are getting a boost from a new online RN-to-BSN program at the University of Charleston (UC) in the state capital. The program, which will begin in the spring, will allow registered nurses (RNs) to complete requirements for a bachelor of science in nursing (BSN) degree in as little as 18 months.
The university’s president, Ed Welch, PhD, said in a news release that the program “answers an immediate need of West Virginia’s health care facilities. By completing their bachelor’s degree at UC in just 18 months, and continuing to work full time, nurses are able to advance their careers and better serve patients in the field.”
Robert Wood Johnson Foundation Executive Nurse Fellows program alumnus Duane Napier, MSN, RN-BC, formerly executive director of the West Virginia Center for Nursing, is the UC RN-BSN program coordinator. “We’ve had a great response since announcing the program,” Napier said in an interview. “It's the state's first online program that doesn't require any campus sessions, so it's truly designed for the working nurse.”
Graduates of entry-level baccalaureate and master’s nursing programs are much more likely to have job offers by graduation or soon after, compared with graduates from other fields, according to new data from the American Association of Colleges of Nursing (AACN). A national survey of deans and directors from U.S. nursing schools found that 59 percent of new bachelor of science in nursing (BSN) graduates had job offers at the time of graduation.
That’s substantially higher than the national average across all professions (29.3 percent). At four to six months after graduation, the survey found that 89 percent of new BSN graduates had secured employment in the field.
“Despite concerns about new college graduates finding employment in today’s tight job market, graduates of baccalaureate nursing programs are finding positions at a significantly higher rate than the national average,” said AACN President Jane Kirschling. “As more practice settings move to require higher levels of education for their registered nurses, we expect the demand for BSN-prepared nurses to remain strong as nurse employers seek to raise quality standards and meet consumer expectations for safe patient care.”
Heather J. Kelley, MA, is deputy director of the Robert Wood Johnson Foundation’s (RWJF) Future of Nursing Scholars program. Prior to this role, she was the program associate for RWJF’s Interdisciplinary Nursing Quality Research Initiative and a former vice president in a political advertising firm.
Three years ago, the Initiative on the Future of Nursing at the Institute of Medicine (IOM) set a revolution in motion with the release of The Future of Nursing: Leading Change, Advancing Health report. Among the bold recommendations offered in the report was the call to double the number of nurses with doctoral degrees by 2020.
RWJF recognizes the valuable contributions that PhD-prepared nurse scientists and researchers make in the lives of patients and families. Their discoveries have the potential to change our health care system. However, as the IOM report suggested, we do not have nearly enough doctorally prepared nurses seeking new solutions to ongoing problems. Currently, less than 1 percent of the nursing workforce has a doctoral degree in nursing or a related field.
Around the country, print, broadcast, and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni, and grantees. Some recent examples:
As the demand for nurses continues to grow and more people go into the field, it is important to encourage a focus on community-based health and population health, Yvonne VanDyke, MSN, RN, told Austin, Texas, NBC affiliate KXAN. Van Dyke is an RWJF Executive Nurse Fellow and senior vice president of the Seton Clinical Education Center in Austin, which is seeking to increase the number of nurses earning Bachelor of Science in Nursing degrees.
A new program funded by the RWJF New Jersey Health Initiatives (NJHI) is enlisting ex-military members to help enroll people in insurance plans in the state. NJHI Director Robert Atkins, PhD, RN, an RWJF Nurse Faculty Scholar alumnus, told New Jersey Spotlight that veterans are well suited to the job of insurance-application counselors because “they know about service, they know about working in teams.” The New Jersey Hospital Association is hiring 25 veterans as certified applications counselors with the $1.8 million NJHI grant.
Diverse Education profiles RWJF Harold Amos Medical Faculty Development Scholar alumnus and National Advisory Committee member Levi Watkins Jr., MD, about his work to promote diversity at Johns Hopkins Hospital. “The best way to recruit minority students is by example … and the intervention of mentors,” Watkins said. “Students don’t look at recruitment and diversity offices when they are choosing schools, but they want to see if there are faculty and students in the place that look like them.”
Rita K. Adeniran, DrNP, RN,CMAC, NEA-BC, is director of diversity and inclusion-global nurse ambassador at the Hospital of the University of Pennsylvania, and a Robert Wood Johnson Foundation Executive Nurse Fellow (2012-2015).
It is exciting and humbling to witness and talk about the positive transformation that nursing has been experiencing since the release of the 2010 Institute of Medicine (IOM) report on the future of nursing. The report emphasizes development of leadership programs that harness nurses’ capacity to lead change, and advance health and health care by creating innovative opportunities for education and professional growth. In addition to many other recommendations, the report calls for interdisciplinary collaboration and underscores the imperative for diversity of the nursing workforce to more appropriately reflect the diversity of the United States population.
More than ever before, nurses are recognized as key to leading successful and sustainable health care for the nation. Nurses are at the forefront of health and health care improvements, leading many quality initiatives. Comprehensive, cost-effective patient and family-centered models of care led by nurses are increasingly becoming popular.
With more nurses obtaining advanced degrees and practicing to the fullest extent of their education and skills, they are engaging side by side with members of interdisciplinary care teams to collaborate in clinical practice, and conduct research and enquiry that can provide solutions to some long-standing clinical problems.