the kansas action coalition: creating a culture of health for kansans jill peltzer, phd, aprn-cns,...
TRANSCRIPT
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 report1. Remove scope of practice
barriers5. Double the number of nurses
with a doctorate by 2020
2. Expand opportunities for nurses to lead & diffuse collaborative improvement efforts
6. Ensure that nurses engage in lifelong learning
3. Implement nurse residency programs
7. Prepare and enable nurses to lead change to advance health
4. Increase the proportion of nurses with a BSN to 80% by 2020
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
Health professionalsPayers
Consumer advocatesBusiness Policy-makers
Philanthropies
Educators
Hospitals and health systems
Public health agencies
Campaign supporters
State Action Coalitions
KSAC promotion video
Kansas action steps
PracticeWorking to full extent of Practice for RNs as well
as APRNs• 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
EducationDevelopment of
standardized prerequisites
• Discuss and develop model for statewide academic progression
• Encourage lifelong learning- create webinar focused on importance of continuing education throughout the lifetime
LeadershipBased upon a needs
assessment through the Leadership and
Mentorship Survey work has begun to develop:
• 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
AdvocacyAdvance the health of
Kansans by championing
nursing’s capacity to transform health and
healthcare• Build capacity for
advocacy; how to advocate for KSAC
• Create an elevator speech for nurse champions
• ID outside groups to connect with
Interprofessional Collaboration Diversity Data#8 Build an infrastructure to collect & analyze interprofessional health care workforce data
KS Action Coalition Partners
NURSE PARTNERS NURSE CHAMPIONSUniversity 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 AARP, Inc.
Kansas Organization of Nurse Leaders
Kansas State Nurses Association
Kansas State Board of Nursing
KCCN – Kansas Council for Collaboration in Nursing
KSACData Collection Efforts
Completed and ongoing studies
1. RN Workforce Survey2. Leadership & Mentor Survey3. RN-BSN Program Survey4. Cultural Competency Survey
a. Individual nursesb. 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
2012 Kansas RN Population
Kansas RN WorkforceSurvey Sample
Gender
Age
Race
92 % Female
92% White
31% < 40 yrs53% 41-60 yrs16% > 61 yrs
92 % Female
89% White
36% < 40 yrs48% 41-60 yrs16% > 61 yrs
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 academicsClinical Area (for the ~4,800 in direct care)• 13% med/surg• 11% ambulatory care• 8% pediatrics• 6% intensive/critical careNursing Role• 49% work in staff nurse role• 11% work in nurse manager role
Education level at initial licensure = 46.3% BSNCurrent education level = 60.5% BSN
Diploma Associate BSN or Higher
0
500
1000
1500
2000
2500
3000
3500
4000
4500
923
2594
3035
589
2039
4029
Initial Nursing Educa-tion (n = 6552)
Current Nursing Educa-tion (n = 6657)
60.5%
8.8 %
30.6%
14.1%
39.6%
46.3%
Num
ber o
f Reg
iste
red
Nur
ses
Nursing Education Levels
Current nursing education levels among KS RNs were comparable to the national
level
Diploma
Associate
BSN or Higher
0% 10% 20% 30% 40% 50% 60% 70% 80%
9%
31%
60%
11%
28%
61%
National RNsKansas 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
DemographicsAge, in years 47.7 47.0 44.0 - 49 - 46 50
20-39 years 29% 35% 42% 34% 30% - 32.3% -40-59 years 52% 45% 45% 46% 52% - 51.0% -≥ 60 years 19% 20% 13% 20% 17% - 16.7% -
Gender Female 92.1% - 94.4% 94.8% - 91.1% 88.3% 93%Male 7.9% - 5.6% 5.2% - 8.9% 11.7% 7%
Race/Ethnicity White/Caucasian 91.9% 90% 94.4% - 57% - 63.0% 83%Minority 8.1% 10% 5.6% - 43% - 37.0% 17%
EducationInitial Nursing Education
Diploma 14.1% - 17.8% 16% 14.5% - 10.8% 23%ADN 36.6% - 28.5% 55% 50.4% - 49.0% 39%BSN or higher 46.3% - 53.7% 29% 35.1% - 40.2% 38%
Current Nursing Education Diploma 9% 9% 16.0% 10.5% - 7.9% 7.0% 11%ADN 31% 35% 25.6% 44.5% - 42.6% 40.8% 28%BSN or higher 60% 56% 58.4% 45.0% - 49.5% 52.2% 61%
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.pdf2. 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.
Comparisons with other states…
KS MO1,2 NE3 IA4 NM5 OK6 TX7 National8
LicensingAPRN Licensing
Nurse Practitioner 57.7% 72% 68% 74.6% 77% 60% 66.6% 54%Clinical Nurse Specialist 21.7% 6% 8% 3.0% 9.6% 10% 8.2% 30%CRNA 14.8% 21% 22% 18.5% 13.2% 27% 22.8% 12%Certified Nurse Midwife 2.6% 1% 2% 3.9% - 3% 2.4% 4%
Employment
Actively Employed in Nursing 90.6% - 98.7% 91.4% 89.7% 77% 89.4% 82%
Full-time 84.0% - - 77.0% 78.4% - 87.3% 60%Employment Settings
Academic setting 8% 2.7% 5.4% - 2.2% 2.8% 1.6% 3%Ambulatory care setting 16% 1.9% 13.9% 21% 12.5% 5.5% 7.3% 9%Community/Public health 5.7% 2.1% 6.6% - 2.9% 4.2% 1.9% 4%Hospital 48% 59% 56.6% 59% 54.4% 61.7% 65.5% 56%Nursing home/extended care/assisted living facilities
5.7% 4.5% 10.5% 6% 3.9% 4.9% 3.0% 6%
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
Graduates Enrollment0
200
400
600
800
1000
1200
1400
269
939
391
1275
407
1203201320142015
20 - 40 Years
41 - 60 Years
> 60 Years0%
10%
20%
30%
40%
50%
60%
70%
80% 73%
26%
1%
61%
39%
0%
66%
33%
1%
201320142015
Female Male0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%90%
10%
90%
10%
88%
12%
2013
2014
2015
AI/NA Asian Black Hispanic Caucasian Other0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
1% 2%
10%5%
69%
13%
0% 3%6% 7%
78%
5%1% 3%
8% 6%
75%
6%
2013
2014
2015
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 nHealthcare 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 nLack 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 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.
2 Education and Training in Culturally Competent Care: Nurses shall be educationally prepared to provide culturally congruent health care.
3 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.
4 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.
5 Culturally Competent Practice: Nurses shall use cross-cultural knowledge and culturally sensitive skills in implementing culturally congruent nursing care.
6 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.
7 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.
8 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.
9 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.
10 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.
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 6-10) were less likely to be integrated into the curricula, especially Guideline #9 (cross-cultural leadership)
Integration of culturally competent content into curricula
KSAC Products
Resources for academic progression
Mentoring program
KSAC 2015 Summer Summit
Creating a Culture of Health in Kansas: Advancing Nursing Education and Leadership
Acute
Care
Long-
Term
CarePubl
ic Heal
th
School
Hays
Pittsburg
Kansas City
Wichita
Acute Care
Long-Term Care
Public Healt
h
School
Acute
Care
Long-
Term
CarePubl
ic Heal
th
School
Acute
Care
Long-
Term
CarePubl
ic Heal
th
School
Northwest Region
Southeast Region
Northeast Region
Southwest Region
Final Meeting LocationTopeka, KS
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
Diversity in Nursing
What can we do in our communities to build a culture of health?
Creating a culture of Health in Kansas
Call to Action
• Education Team• Seamless academic progression
• Practice Team• Full scope of practice
• Leadership Team• Leadership development
• Advocacy Team• Advocacy/policy
development
Visit us on the Webhttp://www.kansasactioncoalition.com
http://campaignforaction.org/
Follow us on twitterwww.twitter.com/kansasac
https://twitter.com/Campaign4Actionhttp://twitter.com/championnursing
Join us on Facebookwww.facebook.com/kansasac
https://www.facebook.com/futureofnursing#!/CampaignForAction http://www.facebook.com/championnursing
More Information
Join us!
Send inquiring e-mail to:
Jon Teel [email protected]
Catch us on Facebook & Twitterhttp://facebook.com/kansasachttps://twitter.com/#!/KansasAC