Category Archives: Nurses
With so many aspects of the nation’s health care system undergoing significant change, many of the nation’s nursing schools have implemented curricular innovations aimed at ensuring that new nursing graduates are fully prepared for the challenges they’ll face in practice. These include working collaboratively in teams, providing evidence-based care, managing chronic conditions, coordinating complex care, and promoting a culture of health—and much more transformation lies ahead.
According to the latest issue of Charting Nursing’s Future, the Robert Wood Johnson Foundation’s (RWJF) issue brief series focused on the future of nursing, most clinical nursing education programs still emphasize hospital-based care, as they have for decades, even though much care has shifted to community settings. This results in a widening gap between clinical nursing education and the 21st-century competencies nurses need.
The brief highlights curricular innovations at a number of nursing schools around the nation, including re-sequencing of the curriculum, using a “concept-based” approach, a “coach model” supporting an online baccalaureate (BSN) degree, new types of academic/practice partnerships, and more. Increasingly, nursing schools are restructuring their students’ clinical experiences, embracing:
- Simulation, using actors posing as patients, complex high-fidelity mannequins, or virtual reality. A newly released and eagerly awaited study by the National Council of State Boards of Nursing (NCSBN) offers powerful support for the trend toward simulation. It found no differences in licensure pass rates or other measures of overall readiness for practice between new graduates who had traditional clinical experiences and those who spent up to 50 percent of their clinical hours in simulation.
Timothy Landers, PhD, CNP, and Jason Farley, PhD, MPH, CRNP, are Robert Wood Johnson Foundation (RWJF) Nurse Faculty Scholars. In his work, Landers focuses on the epidemiology and prevention of antibiotic-resistant infections, including the use of hand hygiene as a means of prevention. Farley evaluates treatment outcomes in multi-drug resistant infections including tuberculosis (TB) and Methicillin-Resistant Staphylococcus aureus (MRSA) in patients with HIV, with a focus on sub-Saharan Africa.
The recent outbreak of Ebola virus in West Africa is a stark reminder that we live in a globally connected world and that outbreaks can occur without warning. As infection prevention specialists, we are acutely aware of the risks health care workers face in caring for the public, both now and in times of relatively less chaos.
The good news is that despite media reports, nurses, physicians, infection prevention specialists and other health care workers are in an ideal position to lead the global response to this disease.
Our experience with measures to address hospital-acquired infections—isolation precautions, hand hygiene, contact tracing and public health measures—are also the same methods necessary to contain the spread of Ebola.
Building on experience addressing these infections, along with recognition of the differences in Ebola virus transmission, the Centers for Disease Control & Prevention (CDC) regularly updates the guidelines and is currently recommending enhanced versions of isolation precautions, including enhanced standard precautions, contact precautions, and droplet precautions.
Twelve talented early-career nurse faculty have been selected as the seventh cohort of Robert Wood Johnson Foundation (RWJF) Nurse Faculty Scholars. The award is given to individuals who show outstanding promise as future leaders in academic nursing.
Each scholar receives a three-year $350,000 award to pursue research, leadership training in all aspects of the faculty role, and mentoring from senior faculty at his or her institution. The scholars chosen this year are using their grants to study a range of issues, from pediatric asthma to dementia care to health literacy to HIV treatment to the use of technology to improve access and outcomes for rural and uninsured individuals.
At a time when many schools of nursing are turning away qualified applicants because they do not have the faculty to teach them, RWJF’s Nurse Faculty Scholars program is helping more junior faculty succeed in, and commit to, academic careers. The program also is strengthening the academic productivity and overall excellence of nursing schools by developing the next generation of leaders in academic nursing.
Patricia Drehobl, MPH, RN, is associate director for program development at the Centers for Disease Control & Prevention (CDC). She is an alumna of the Robert Wood Johnson Foundation (RWJF) Executive Nurse Fellows program (2007-2010).
Human Capital Blog: CDC is engaging in new partnerships with the American Association of Colleges of Nursing (AACN) to promote public health nursing. How did the new collaboration come about?
Pat Drehobl: CDC has funded some national academic associations for many years, including the Association of Schools of Public Health, the Association of Prevention Teaching and Research, and the Association of American Medical Colleges. We recognized the need to include nursing representation because nursing is the largest discipline in the public health workforce. We added AACN as a partner in 2012 when we developed our funding opportunity announcement to work with academic partners.
HCB: Why did CDC decide to reach out to the nursing community in 2012?
Heather J. Kelley, MA, is deputy director of the Robert Wood Johnson Foundation (RWJF) Future of Nursing Scholars program.
“Being selected as a Robert Wood Johnson Foundation Future of Nursing Scholar was such an honor! I was already excited about starting my PhD program, but this took that excitement to another level. I wasn't sure what to expect from the boot camp, but it was truly transformative.” - Laren Riesche, a Future of Nursing Scholar attending the University of Illinois at Chicago.
Riesche was one of the 16 new scholars I was privileged to meet on August 5 and 6 at our program’s first-ever scholars’ event. In addition to providing financial support to nurses to complete their PhDs in three years, the Future of Nursing Scholars program will also provide a series of leadership development activities. One of these activities is a boot camp which will be held for each cohort prior to the start of their doctoral programs.
The first-ever boot camp was a two-day event at which the scholars were able to meet and connect with one another, and begin the work of developing skills that will serve them well as they pursue their PhDs. Sessions addressed crucial issues, including developing strategies for peer coaching, and identifying and understanding one’s own approach to change and exerting influence. The new scholars met with current doctoral students to discuss a variety of issues and were given time to network with program leaders, guest speakers, and each other. A workshop served as an introduction to scholarly writing and the event closed with a panel on selecting and working with mentors.
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. Following are some of the stories in the October issue.
Campaign Helps Advance Institute of Medicine's Call for More Nurse Leaders
On the fourth anniversary of the release of the Institute of Medicine’s (IOM) landmark report on the future of the nursing profession, more nurse leaders are stepping into positions of power and influence—and efforts to prepare even more nurses for leadership are gaining ground. Today, the Future of Nursing: Campaign for Action is putting new emphasis on the report’s leadership recommendation, and nurses and their employers in government and other sectors are responding. The Campaign is a joint initiative of RWJF and AARP.
Nursing Improvements Could Boost Outcomes for 7 Out of 10 Critically Ill Black Babies
A new study funded by RWJF’s Interdisciplinary Nursing Quality Research Initiative and the National Institute of Nursing Research provides insight into the issue of very low birth weight (VLBW) infants, who are disproportionately black. Researchers found that nurse understaffing and practice environments were worse at hospitals with higher concentrations of black patients, contributing to adverse outcomes for VLBW infants born in those facilities.
California has “Well-Educated” Nurse Force, Study Finds
While California has a “well-educated” nurse force, a survey published by the state’s Board of Registered Nursing shows that there is a long way to go toward meeting the goal set forth by the Institute of Medicine’s landmark report on the future of nursing that 80 percent of nurses hold bachelor’s degrees or higher by 2020. About 60 percent of the state’s registered nurses have earned a bachelor’s or graduate degree in nursing or another field, the survey found. Nearly 40 percent of respondents—and nearly 80 percent of those under 35—said they are considering or seriously considering additional education.
Risa Lavizzo-Mourey, president and CEO of the Robert Wood Johnson Foundation (RWJF), was honored by the American Academy of Nursing (AAN) yesterday, receiving the President’s Award from the venerable institution.
The presentation was made by AAN President Diana Mason, PhD, RN, FAAN, at its conference, Transforming Health, Driving Policy Conference. Lavizzo-Mourey, MD, MBA, spoke to the assembled conference participants via video. “At the Robert Wood Johnson Foundation, we like to say that nursing is in our DNA. That’s because we believe to our core that nurses are the glue that holds together our health care system across the entire continuum of an individual’s lifespan ... We envision a future where all Americans realize a new and robust Culture of Health ... We cannot and we will not ever achieve a Culture of Health without the support, help and the leadership of nurses.”
“I am grateful to be honored with this award,” Lavizzo-Mourey continued. “And know that you are all committed to transforming health, leading change, influencing policy, and ultimately improving the nation’s health ... And I am humbled to be in the company of this year’s FAAN inductees and the Living Legend honorees who will be recognized tonight. Congratulations to everyone – and a shout-out to those who are RWJF scholars, fellows and alumni.”
Some 170 people will be inducted as fellows of AAN (FAANs) tomorrow. They include four RWJF Executive Nurse Fellows, eight RWJF Nurse Faculty Scholars, two RWJF Interdisciplinary Nursing Quality Research Initiative investigators, and Mary Dickow, MPA, the statewide director of the California Action Coalition of the Future of Nursing: Campaign for Action.
Want to stay on top of the latest news from RWJF? Check out all the ways you can get the latest news delivered to you:
· Sign up for Content Alerts, newsletters, and funding alerts
· Sign up to receive Charting Nursing’s Future policy briefs
· Stay up to date on the Future of Nursing: Campaign for Action
Linda H. Aiken, PhD, RN, FAAN, is the Claire Fagin Professor of Nursing, professor of sociology, director of the Center for Health Outcomes and Policy Research, and senior fellow of the Leonard Davis Institute for Health Economics at the University of Pennsylvania. Olga Yakusheva, PhD, is an associate professor at the University of Michigan School of Nursing.
Four years ago the Institute of Medicine’s (IOM) landmark report on the future of nursing was released. The study was remarkable in multiple respects including the interdisciplinary perspectives of national experts comprising the study committee, the breadth and scope of the study, its actionable recommendations, and the commitment of the Robert Wood Johnson Foundation (RWJF) to provide philanthropic funds to help implement the study’s recommendations—a rarity. One net result of the IOM Report, as viewed on the 4th anniversary of its release, is its notable impact on the commitment of stakeholders to finally make the transition of the nation’s nurse workforce to BSN qualifications, after many decades of limited progress.
Changing trends in nurse employment and education: The IOM recommended that 80 percent of nurses in the United States hold at least a baccalaureate in nursing (BSN) by the year 2020. The recommendation was quite bold considering that two-thirds of new nurses still graduated with less than a BSN, despite numerous previous reports and commissions over decades recommending the BSN as the entry qualification for professional nurses.
While the percentage of nurses with bachelor’s and graduate education had been slowly increasing over time, when the IOM report was issued only about 49 percent of nurses held a BSN. However, the IOM’s recommendation, based upon a growing research base documenting that patient outcomes were better in settings that employed more BSN-qualified nurses, acted as a tipping point to mobilize responses from many stakeholders that together are impacting changes in nurses’ qualifications.
Nurses truly run the front lines of hospitals. Their leadership oversees every hospital quality initiative essential to improving care—from reducing hospital-acquired infections, to cutting unnecessary readmissions, to preventing patient falls.
Poor scores in these quality measures now result in government penalties that can hit hospitals hard.
And as health care evolves and hospitals stretch beyond their own walls, nurses are leading the programs that bring health care into communities. They are critical to the success of health reform as more Americans obtain health insurance and seek primary care.
So tell me something? Why is the highest level of hospital leadership in our nation nearly devoid of nurses?
Surveys find the number of nurses with voting positions on hospital boards is about 4 to 6 percent — an unfathomable statistic for anyone who understands, even a little, how hospitals work.
We need the leadership of nurses on every hospital board.