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Educational ChallengesChanging Roles

E-Line Military

Diversity in NursingMalesFacts11.4% of pre licensure students are male9% of DNP students are male7.5% of PhD students are male6.2% are practicing nurses are maleMany are in the militaryIssueFew role models and mentorsDukes model

Ethnic Diversity in Nursing

Changes in Nursing EducationCompetency-based curriculaCommunity colleges moving rapidly toward teaching concepts over the curriculum and not block courses.ExamplesReduction in credit hours for both the Associate degree and the BSNAssociate degree to 60 hoursBSN to 120 hoursAttempt to standardize the prerequisites.

Changes in Nursing EducationCurriculummajor areas of focus in a new nursing education curriculum should include interprofessional collaboration, communication, and systems thinking.

Life-long learningnurses must keep up with new knowledge and new technology to ensure quality patient care.

Changes in Nursing EducationTechnologysimulations and other types of technology that encourage critical thinking and problem solving are important to adequately prepare the required number of nurses for the future.Articulationcurricula and educational programs should be structured to enable the learner to progress from basic to advanced education with minimal disruption.

Changes in Nursing EducationOlder adult caregiven the shift in age range of the population of the United States, significant time and emphasis must be allocated to student learning about geriatric care, management of chronic conditions, and community-based practice.Technologysimulations and other types of technology that encourage critical thinking and problem solving are important to adequately prepare the required number of nurses for the future.

Changes in Nursing EducationArticulation

Professionalism nursing education must include empowering students to be active players in the healthcare environment

Changes in Nursing EducationCarnegie Report (Patricia Benner)

Nursing education in the traditional formats is not working to prepare nurses to practice in todays complex healthcare environment.

The Carnegie Report on Nursing EducationA report was issued early in 2010 (Benner, et al) from the Carnegie Foundation. This report was the culmination of several years worth of work by a group of stakeholders in the nursing education and practice environments. After thorough analysis of the current landscape of nursing education, the report concluded that education in the traditional formats is not working to prepare nurses to practice in todays complex healthcare environment. A number of recommendations were made, including better articulation between programs. This would allow students to begin their healthcare careers as LPNs or associate degree graduates, then advance to baccalaureate or higher education with minimal roadblocks.Another recommendation from this report is that the curricula currently used by schools of nursing, focusing on performance of nursing tasks or skills, must be significantly changed. Rather, the focus of undergraduate education should be on development of knowledge, skills, and abilities to function in a complex healthcare system. Students entering nursing today need to be knowledgeable about topics such as leadership, cultural diversity, advocacy, and evidence- based practice.Subsequent to academic preparation, a nurse residency program is recommended. Residency for nurses, similar to that for new physicians, would enable the nurse to gradually increase knowledge and skills specific to the desired area of practice. Clinical practice would be combined with a continuation of formal learning opportunities to facilitate development of critical thinking and clinical judgment. A residency program is not the same as orientation or preceptor- based learning. The residency program is a formal blend of academic and clinical experiences that focus on application of knowledge and skills in the clinical setting, while continuing to learn and develop skills in interprofessional collaboration. Some residency programs are currently in use, and reports of their value have been positive.

10Changes in Nursing EducationRecommendationsBetter Articulation between programsthe curricula currently used by schools of nursing, focusing on performance of nursing tasks or skills, must be significantly changed. Focus of undergraduate education should be on development of knowledge, skills, and abilities to function in a complex healthcare system. Students entering nursing today need to be knowledgeable about topics such as leadership, cultural diversity, advocacy, and evidence- based practice.Residency Programs

Interprofessional Collaborative Care The effect of Interprofessional Care Teams on Intensive Care Unit MortalityLikelihood of Death within 30 Days of ICU AdmissionICUS without daily Interprofessional Rounds 19.1%ICUS with daily Interprofessional Rounds 16.2%

A study of critically ill patients admitted to 1169 Pennsylvania hospitals over the course of two years found that daily rounds by an interprofessional ICU team were associated with a significantly reduced risk of death.

Conventional VS Collaborative CareConventional AuthoritarianAutonomous practice culturePhysician Driven, MDs responsible for outcomes Episodic, fragmentedPrimary Care delivered in one size fits all 15 minPayment based on quantity (fee for service)Reactive, Focused on illnessCommunication is inconsistent

Collaborative CareCollaborativeTeam CulturePatient centered, with team members sharing responsibility for outcomes.Continuous, coordinatedPrimary care delivered via ind. Visits, phone calls, and online communicationsPayment based on valuePreventive, focused on healthCommunication is imperative

Core Competences for IPCValues/ethics for Interprofessional PracticeMutual respectShared valuesRoles/Responsibilities for Collaborative PracticeUse knowledge of ones own role and those of other professions Assess and address the health care needs of patients and populations served.Interprofessional CommunicationCommunicate with patients, families, communities, and other health professional in a responsive and responsible manner that supports a team approach in maintenance of health and treatment of diseaseInterprofessional Teamwork and Team-Based Care

Interprofessional TeamworkInterprofessional Teamwork and Team-Based CareApply relationship building values and the principles of team dynamics to perform effectively in different health roles to plan and deliver patient population centered care that in ss safe, timely, efficient, effective , and equitable.