Category Archives: Continuing education
A year ago this week, the Robert Wood Johnson Foundation (RWJF) convened an unprecedented meeting that brought together diverse leaders from community colleges around the country, the Tri-Council for Nursing, and RWJF’s Academic Progression in Nursing (APIN) initiative, which is fostering collaboration between community colleges and four-year university nursing programs to promote seamless academic progression for nurses. The meeting was organized to address concerns in the community college community about the recommendation in the Institute of Medicine’s (IOM) report, The Future of Nursing: Leading Change, Advancing Health, that 80 percent of the nation’s nurses attain bachelor of science in nursing or higher degrees by the year 2020.
A paper, released today, reports on the proceedings of that meeting, including participants’ shared goal to ensure that community colleges continue their invaluable work to educate a new generation of nurses and diversify the nursing workforce; and to give all nurses opportunities to be lifelong learners who are well-prepared to provide high-quality care and promote health.
The paper includes an addendum that provides news and information about how nursing, health, education, government, business, and other leaders in nine states have made exciting progress in the last year in support of seamless progression for nursing students, as well as for nurses already in the workforce who wish to continue their education.
“While we did not solve every concern, the meeting was tremendously constructive, opening a dialogue, identifying numerous areas of strong agreement, and illuminating issues yet to be resolved,” said John Lumpkin, MD, MPH, senior vice president at RWJF. The Foundation “is determined that last year’s meeting be a beginning for a continuing, constructive dialogue that will advance the goals we all share.”
Susan B. Hassmiller, PhD, RN, FAAN, is co-director of the Future of Nursing Scholars Program and senior adviser for nursing for the Robert Wood Johnson Foundation (RWJF). The Future of Nursing Scholars program’s call for proposals will close on April 15. It is open to schools of nursing with research-focused PhD programs. The schools that receive awards will select the scholars to support.
I started my nursing career at a community college. It was a terrific experience that left me as prepared as I could be for my beginning staff nurse role. I quickly discovered that I wanted and needed to know more, however, so I returned to school. Over the next several years, I earned a PhD in nursing administration and health policy. It was difficult but incredibly rewarding and has led to a career I could never have imagined when I started out, including serving as a faculty member at the University of Nebraska and George Mason University. That experience has made me want to “pay it forward”—to pay homage to the nurses who mentored and encouraged me on my journey.
Serving as co-director of the Future of Nursing Scholars program is part of my personal mission to help other nurses who want to follow the same path. It also is a big part of RWJF’s extraordinary, long-term support for the nursing profession, which advances the Foundation’s mission to improve health and health care, and build a culture of health in this country.
Supporting nurses seeking PhD degrees is tremendously important. Because nurses have vast experience working directly with patients and families, we are positioned to help make care safer, more accessible, and higher quality. In particular, PhD-prepared nurse scientists and researchers are in a unique position to identify solutions that make a real difference to patients and families. But, as the Institute of Medicine (IOM) noted in its landmark report, The Future of Nursing: Leading Change, Advancing Health, the country will need many more PhD-prepared nurses in coming years.
Ten years ago, a report from the Institute of Medicine (IOM) proposed a transformation of nurses’ workplaces, warning that “The typical work environment of nurses is characterized by many serious threats to patient safety.” The latest issue of the Charting Nursing’s Future policy brief series from the Robert Wood Johnson Foundation (RWJF) focuses on how much has changed in the intervening years, and how much remains to be done.
The new brief identifies a series of initiatives designed by and for nurses that have “spurred the creation of work environments that foster health care quality and patient safety.” Among them:
- The RWJF-backed Transforming Care at the Bedside (TCAB) initiative, developed in collaboration with the Institute for Healthcare Improvement, which seeks to empower frontline nurses to address quality and safety issues on their units, in contrast with more common, top-down improvement efforts. TCAB is now integrated with Aligning Forces for Quality (AF4Q), RWJF’s signature effort to improve the quality of health care and reduce disparities in targeted communities.
- Another RWJF-backed project, Quality and Safety Education for Nurses (QSEN), focuses on nursing school faculty, and has helped prepare thousands teaching in graduate and undergraduate programs to integrate quality and safety competencies into nursing school curricula.
- On the policy side, efforts have been made to further examine and improve the adequacy of nurse staffing. For example, a number of jurisdictions, including California, Illinois, Washington state, and Minnesota, have adopted standards that either require or encourage limits on how many patients a given nurse may be assigned to care for in acute care hospitals. Subsequent research has demonstrated an impact on hospital policies, but evidence of improvements in cost, quality, and safety is mixed so far.
- A number of institutions, including Vanderbilt University Medical Center in Nashville and The Johns Hopkins Hospital in Baltimore, have taken aim at disruptive behavior and professional discourtesy in the workplace, noting that, given the growing importance of teamwork and collaboration, the consequences of such misbehavior can be “monumental when patients’ lives are at stake.”
As the patient-centered medical home (PCMH) has emerged as a model for providing effective team-based care that can help offset the impending primary care provider shortage, so, too, is there a growing need for educational strategies that promote interprofessional collaboration. A short report published online by the Journal of Interprofessional Care describes the strategies in place at the VA Connecticut Healthcare System Center of Excellence in Primary Care Education (CoEPCE) and indicates promising results in just one year: doubled productivity in patient care delivered by faculty providers, and a marked increase in same-day clinic access for patients receiving care from an interprofessional team.
The Connecticut CoEPCE, like four other program sites funded through the U.S. Department of Veterans Affairs Office of Academic Affiliations, builds on the VA’s system-wide PCMH model, known as Patient Aligned Care Teams (PACT). It seeks to develop exportable models of interprofessional education and patient care, according to the report, “Moving From Silos to Teamwork: Integration of Interprofessional Trainees Into a Medical Home Model.” The CoEPCE sites share four core curricular domains—shared decision-making, sustained relationships, interprofessional collaboration, and performance improvement—and the Connecticut center groups together physician, nurse practitioner (NP), pharmacy, and health psychology trainees.
The trainees divide their time evenly between interactive educational sessions and caring for patients, guided by faculty who provide supervision, mentorship, and collaborative shared care. Additionally, the Connecticut center incorporates a one-year post-master’s adult NP interprofessional clinical fellowship, to further enhance clinical proficiency and teamwork experience for NPs.
RWJF Scholars in the News: Military suicides, easing the path to a BSN, early clues to lung cancer, and more.
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:
Amid growing attention to suicide rates among members of the military, a new series of studies explores the contributing factors, the New York Times reports. One of the studies, on suicides and accidental deaths, was led by RWJF Scholars in Health Policy Research alumnus Michael Schoenbaum, PhD. He identified a host of risk factors, including demotions, low rank, and previous deployment. However, Schoenbaum did not find evidence to support the contention that relaxed recruitment standards had led to the induction of soldiers more likely to commit suicide. The study was also covered in USA Today, the Wall Street Journal, and the Guardian, among other outlets.
The North Carolina Medical Journal features an article by Polly Johnson, RN, MSN, RN, FAAN, on the Regionally Increasing Baccalaureate Nurses (RIBN) initiative. It provides an economically feasible educational pathway between community colleges and universities so that more North Carolina nursing students can achieve a baccalaureate degree at the start of their careers. RIBN is supported by RWJF’s Academic Progression in Nursing initiative.
In her work as a nurse practitioner in a pediatric ICU, Karin Reuter-Rice, PhD, CPNC-AC, has observed that some children with traumatic brain injuries improve rapidly, while others suffer grave and permanent damage, reports Duke Nursing. As a result, Reuter-Rice, an RWJF Nurse Faculty Scholar, is using her RWJF grant for a multi-year research project to determine what neurological differences account for those dramatically different outcomes. She is exploring whether vasospasm, the sudden contraction of blood vessels in the brain, might play a role.
An Interview with Julie A. Fairman, PhD, RN, FAAN, co-director of the Future of Nursing Scholars program, and Nightingale Professor of Nursing and director, Bates Center for the Study of the History of Nursing, at the University of Pennsylvania.
Human Capital Blog: What is the goal of the Future of Nursing Scholars program?
Julie Fairman: The Robert Wood Johnson Foundation launched the Future of Nursing Scholars program to create a large and diverse cadre of PhD-prepared nurses who are committed to long-term leadership careers that advance science and discovery, strengthen nursing education, and bring transformational change to nursing and health care. It is vitally important that we meet the growing need for PhD-prepared nurses, not only to ensure that we address the shortage of nurse faculty members, but because nurse researchers make valuable contributions to practice and policy. The program will fund schools of nursing to provide scholarships, and it will provide mentoring and leadership development activities to build the capacity of a select group of future nurse leaders. The program’s call for proposals launched this week, and scholars will be selected by the nursing colleges and universities that submit successful program proposals.
HCB: Congratulations on the release of the program’s first call for proposals! As schools begin applying to participate in this program, what would you like them to keep in mind?
Fairman: We are very excited about this program. The major requirement for participation is that research-focused schools of nursing must be ready and able to graduate PhD students in three years. We understand that acquiring a PhD in nursing in three years is not the norm and that many schools have not previously graduated students within that time frame. So, schools are not necessarily ineligible if they have never operated this way, but they will need to provide a thorough description of how they will meet this obligation. We are asking applicant schools to provide information not only about their curricula, but also about their mentoring activities and faculty engagement with research. We also ask that they provide a discussion of interdisciplinary engagement in their institutions, and details about their admission, retention, and graduation of PhD nurses.
Schools that are chosen for the program will be responsible for selecting the scholars who will participate. Schools should select scholars who understand and accept the challenge of completing their PhD degrees in three years. To succeed, the scholars they select will be goal-directed, focused, and committed to long-term academic careers with a focus on science, health policy, and/or innovation. They also should be interested in health policy formulation or in the development of new evidence-based solutions to address health care problems.
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.”
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.
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.”