Kentucky Nursing Capacity Consortium Update

Kim Dees, MSN, RN, MBA/HCMKentucky Hospital Association

Vice President of Health Professions

Sherry Holmes, MSN, RNUniversity of Kentucky College of Nursing

Coordinator of Assessments and Special Projects

Kentucky Organization of Nurse Leaders 8th Annual Conference September 21, 2012 Louisville , Kentucky

• Provide a brief overview of the 2010 IOM Report recommendations on the future of nursing

• Describe the current activities of the Kentucky Nursing Capacity Consortium (KNCC)

• Summarize the outcomes of the Pilot: Supporting Transition to Practice in Rural Kentucky

Objectives

1. Remove scope-of-practice barriers2. Expand opportunities for nurses to lead and diffuse

collaborative improvement efforts3. Implement nurse residency programs4. Increase the proportion of nurses with a baccalaureate

degree to 80% in 20205. Double the number of nurses with a doctorate by 20206. Ensure that nurses engage in lifelong learning7. Prepare and enable nurses to lead change to advance

health8. Build an infrastructure for the collection and analysis

of interprofessional health care workforce data

Institute of Medicine October 2010 Report: The Future of Nursing Leading Change, Advancing Health

KNCC applied to and was selected by the Future of Nursing Campaign for Action to become the Kentucky Action Coalition (KYAC) (9/23/2011)

http://www.campaignforaction.org is the website for the Campaign for Action

Early October the website will be upgraded to have a link to the KYAC for progress reports

Relationship of KNCC and Kentucky Action Coalition

Short term goal - position KYAC to achieve long-term goals (Fall 2011-Fall2012)

Establish plan for strengthening stakeholder base Develop media plan to influence public and health

professions awareness of the IOM Report and KYAC

Complete Rural Residency Pilot and determine need for statewide implementation

KYAC Goals and Objectives

Long term goal - Kentucky will have a highly educated nursing workforce that can practice at full scope (12+ months)

• Actively engage Kentucky nurses in policy making• Reduce barriers for APRN practice • Increase percentage of BSN and doctorally

prepared nurses• Develop tracking mechanisms to measure

outcomes of our work

KYAC Goals and Objectives

Barriers to APRN Practice

80% BSN by 2020

IOM Recommendations:KYAC Focus/KNCC Activities

Barriers to APRN Practice

IOM Recommendations:KYAC Focus/KNCC Activities

Prevent APRNs from ordering some services and performing certain exams

Prohibit reimbursement or provide reduced reimbursement – Medicaid reimburses APRNs at 75% of the physician rate

Complexity of laws produces confusion

Kentucky APRNs may practice independently; however, they must have a Collaborative Agreement for Prescriptive Authority in order to prescribe medications

Kentucky Statutes:Impact on APRN Practice

HB 512 and SB 190 bills, which would have removed the requirement that advanced practice registered nurses have a collaborative agreement with a physician in order to prescribe non-scheduled drugs, did not pass during the most recent legislative session. HB 512 did make it through the approval process within the House. SB 190 was not heard in the Senate.

Advocacy work resulted in additional House and Senator champions for the issue and the plan is to reintroduce the legislation in the next session

Legislative leadership worked with nursing to get the necessary changes made to HB 4 (This bill incorporated increased use of KASPER for reporting and monitoring prescriptions)

Legislative Update 2012

In follow‐up to House Bill 1, the Kentucky Board of Medical Licensure has issued a 39 page document for regulation of prescribing and dispensing medications which is being circulated around the state for comment

Dr. Ardis Hoven (from Lexington) has been elected president of the AMA which may impact the activity of KMA to assure that nothing happens in Kentucky that is in opposition to the AMA agenda

Legislative Preparation 2013

Pay close attention to those running for election this fall in order to determine who nursing should support

The many calls made by KNCC and KNA during the 2012 session were positively noticed by the legislators and their staff

Nursing leaders need to be knowledgeable regarding the legislation that impacts nursing practice so that they can easily educate others

VOTE

Legislative Preparation 2013

80% BSN by 2020

IOM Recommendations:KYAC Focus/KNCC Activities

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Kentucky (2008 National Sample Survey of RNs)

Est. # % Diploma

% ADNKY Est.

#

% BSNKY Est.

#

% MSN/ Doctora

teKY Est.

#US 2,596,5

9912.1% 37.6% 37.3% 13.0%

Kentucky

41,520 - 54.1%22,475

29.8%12,354

11.4%4,748

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Kentucky Board of Nursing RN Current Licensure Count - By Educ. Level & County of Residence http://www.kbn.ky.gov/stats

Kentucky Licensure StatisticsSeptember 2012

Diploma Nsg/RN

Associate Degree/Nsg

Associate Degree/Non-

Nsg Field

Baccalaureate/Nsg

Baccalaureate/Non-Nsg Field

2927 31289 46 18559 1867

Masters/Nsg Masters/Non-Nsg Field

Doctorate/Nsg Doctorate/Non-Nsg Field

5823 1254 266 220

RN-BSN KentuckyAACN, 10 Schools reporting 2010-2011◦Enrolled 708◦Graduated 217

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Exploring barriers to academic progression for Associate Degree nurses

Completed an audit of 11 anonymous transcripts from the technical and community college system

Plan developed with the technical and community college system Associate Degree programs to modify their programs to assure that all graduates are “core certified” in order to reduce the number of credits required at a state supported RN-BSN program in KY

RN-BSN: Barriers to Progression

One year project designed to assist new nurse in the transition from student to practice

Four major components:◦Support sessions for the new nurses◦Local mentoring◦Educational modules delivered via web◦Change Projects

Pilot: Supporting Transition to Practice in Rural Kentucky

Pilot did not provide base line data or conclusive findings due to lack of participation

New nurses and mentors were not given paid time to participate

Information obtained and lessons learned are applicable to the design of future residency programs

Rural Residency Pilot: Findings

KBN and KNCC will hold a joint education conference this fall (November 30 tentative date in Louisville)

Nancy Specter, from the National Council of State Boards of Nursing will deliver the keynote, “Mind the gap: Best Practices for Accelerating the Practice Readiness of Nursing Students”

Participants: hospitals/employers and educators

Joint Education Conference

Accessibility of BSN programs

Legislation regarding prescriptive authority of APRN and Medicaid authority to improve access to healthcare for Kentuckians

Engaging more practice partners into the group

Look at the need for education of nurse educators (MSN for nurse educators)

KNCC/KYAC Priorities for 2012-2013

Commit to take action on recommendations from IOM report, this is about patient-centered care and health care reform, essential that nurses mobilize

Support nurses to advance their education

Optimize the voice of nurses in supporting Kentucky legislature to eliminate barriers to APRN practice

In Conclusion

Institute of Medicine. (2011). The Future of Nursing Leading Change, Advancing Health. Washington, DC: The National Academies Press

Kentucky Board of Nursing RN Current Licensure Count - By Educ. Level & County of Residence. (September 18, 2012) http://www.kbn.ky.gov/stats

U.S. Department of Health and Human Services Health Resources and Services Administration. (September 2010) The Registered Nurse Population Findings from the 2008 National Sample Survey of Registered Nursing http://bhpr.hrsa.gov/healthworkforce/rnsurvey/2008/nssrn2008.pdf

References

Become part of KNCC

Send email to janek@email.uky.edu

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