Healing community pp, 3.1.13

P A U L E T T E C . C O M P T O N , R N , M S N , M C
P R O G R A M D I R E C T O R
B A N N E R B O S W E L L M C C
H E A L I N G C O M M U N I T Y A N N U A L S P R I N G
M E E T I N G
M A R C H 1 , 2 0 1 3
2010 IOM Future of Nursing Report &
Health Care Reform:
Impact on Nursing Practice & Nursing
Education

How is „nursing practice‟
connected to „health care reform‟?
“Many unknowns about health care remain as the
country pushes forward with health care reform. But
one thing is certain. The US cannot adequately
address the challenges facing its health care system
without addressing the challenges facing the nursing
profession. Nurses are the largest segment of the
heath care workforce and are essential to providing
quality care…….The goal of this initiative is to help
transform nursing as part of far-reaching reforms in
the health care system.”
 SOURCE: Preface to Summary of IOM October 2009 Forum on the Future of
Nursing: Acute Care
2
3.1.2013Paulette C Compton, RN, MSN, MC

Inter-Dependent Influences
Health Care
&
Health Care
Reform
Nursing
Education
Nursing
Practice
Health Care =
Reality of current
health care now and
future
Health Care Reform**
= Needed changes in
health care
now and future
3
**ANA website
link:
http://www.n
ursingworld.or
g

Where is the history & evidence US Health Care needs reform?
Jeopardy Answer….‟What is‟ the IOM?
“The Institute of Medicine asks and answers
the nation‟s most pressing questions about
health and health care.”
“The mission of the IOM is to advise the
nation on matters of health and medicine.”
SOURCE: www.iom.edu/About-IOM.aspx
4

What does the IOM do?
“The IOM applies a distinct research process to
provide objective and straightforward answers to
difficult questions of national importance.”
“These leading national and international scientists
[who conduct the studies], all of whom serve as
volunteers, are asked to set aside preconceptions and
to rely on evidence in their pursuit of knowledge and
truth.”
5

What is the IOM?
 Institute of Medicine
 Private, non-governmental, nonprofit organization
providing unbiased and authoritative advice to decision
makers and the public.
 Established in 1970, the IOM is the health arm of the
National Academy of Sciences, chartered under President
Abraham Lincoln in 1863.
 www.iom.edu
6

What is the relationship between education & practice?
Past-Present-Future
Nursing
Practice
Nursing
Education
7

Nursing Practice-Nursing Education
Relationship
 PAST (History):
Very close relationship with diploma programs in
hospitals
 PRESENT:
Disconnected; education silo & practice silo
 NOW & FUTURE:
Need to collaborate on preparing nurse of future
AZ Action Coalition Education-Practice Collaborative Task Force
8

Why are IOM Reports Essential to Nursing
Education?
 The IOM Reports:
1) provide evidence how to improve our healthcare
system
2) provide evidence how to improve the health of
Americans & improve patient outcomes in our
nursing practice
3) IOM focus is also on healthcare professions
education with goal of a consistent framework with
all healthcare professions education emphasizing
interdisciplinary care
SOURCE: Finkelman A & Kenner, C (2009) Teaching IOM: Implications of the IOM Reports for
Nursing Education. ANA: Silver Spring, MD
9

What is the evidence to support need to improve
nursing education & nursing practice?
 1999 IOM To Err is Human
 IOM Quality Chasm series
 2003 IOM Health Professions Education
 2004 QSEN
 2009 Patricia Benner‟s book, Educating Nurses: A
Call for Radical Transformation
 2010 IOM Nurse of the Future, Leading
Change, Advancing Health
10

2010 IOM Future of Nursing Report
Recommendations:
Leading Change, Advancing Health Report
1) Nurses should practice to the full extent of their
education and training.
2) Nurses should achieve higher levels of education and
training through an improved education system that
promotes seamless academic progression.
2) Nurses should be full partners, with physicians and
other health care professionals, in redesigning health
care in the United States.
2) Effective workforce planning and policy making require
better data collection and an improved information
infrastructure.

12

Relationship/Structure of AZ
Education-Practice Collaborative Task Force
Future of Nursing, Campaign for Action
Funded by AARP & RWJF
www.campaignforaction.org
AZ Action Coalition (AC)
www.futureofnursingaz.com
AZ AC Education Task Force
is a sub-committee of AZ Action Coalition (AC)
AZ Education-Practice Collaborative Task Force
is the responsibility of AZ AC Education Task Force
13

IOM & Nursing Education
 “The IOM reports are at the center of the current
restructuring of healthcare systems and the movement
toward inter-professional work, and they influence funding
from research, education, and health policy agencies and
professional organizations. They ( IOM reports) should
therefore be at the core of all nursing education
programs.” Finkelman& Kenner, (2009) Teaching
IOM, P.xvii.
 “Educators often feel they know what needs to be taught
though they have long been out of practice or only practice
intermittently. This is a dangerous stand to take and may
have poorly served students or employers who hire new
graduates. This is also not serving our consumers, patients
and their families.” Finkelman& Kenner, (2009)Teaching
IOM, pp.xviii-xix.
14

1999 IOM Report: To Err is Human
 The report identified remarkably high incidence of errors in
health care. At least 44,000 to 98,000 people die in hospitals
each year in the US as a result of medical errors that could have
been prevented, based on estimates from two major studies.
 Definition of „medical error‟-the failure of a planned action to be
completed as intended or the use of a wrong plan to achieve an
aim.
 The highest incidence of medical errors with serious
consequences occurs more frequently in ICUs, ORs, and EDs.
 Recommendation of need to change to blame-free environment
which does not focus on punishing individuals for errors but
changes to a root cause analysis to determine individual practice
and system problems which result in errors.
15

2001 IOM Report: Crossing the Quality Chasm 2001
 The report found our
health care system is
fragmented, inefficient, an
d poorly organized.
 IOM 1990 definition of
„quality‟-“the degree to
which health services for
individuals and
populations increase the
likelihood of desired health
outcomes and are
consistent with current
professional knowledge.”
 The report identified
„quality‟ as a system
property with six important
improvement aims.
Health care „quality‟ should be:
 Safe
 Effective
 Patient-centered
 Timely
 Efficient
 Equitable
16

2003 IOM Report: Patient Safety:
Achieving a New Standard of Care
 The report identified the need for a much broader approach to
patient safety than was first stated in To Err is Human.
 Definition of „patient safety‟-The prevention of harm to
patients, where harm can occur through errors of commission and
omission.
 The report describes the need for commitment from all stakeholders
to a culture of safety and improved information system, which us
clinical data at point of care to prevent, recognize, and recover from
adverse events.
 Recommended need HHS assume lead role for establishing a
standards-based nation health information infrastructure to support
comprehensive patient safety programs to detect and analyze
adverse events and near misses.
17

Note: * Estimate. Expenditures shown in $US PPP (purchasing power parity).
Source: Calculated by The Commonwealth Fund based on 2007 International Health Policy Survey; 2008
International Health Policy Survey of Sicker Adults; 2009 International Health Policy Survey of Primary Care
Physicians; Commonwealth Fund Commission on a High Performance Health System National Scorecard; and
Organization for Economic Cooperation and Development, OECD Health Data, 2009 (Paris: OECD, Nov. 2009).
AUS CAN GER NETH NZ UK US
OVERALL RANKING (2010) 3 6 4 1 5 2 7
Quality Care 4 7 5 2 1 3 6
Effective Care 2 7 6 3 5 1 4
Safe Care 6 5 3 1 4 2 7
Coordinated Care 4 5 7 2 1 3 6
Patient-Centered Care 2 5 3 6 1 7 4
Access 6.5 5 3 1 4 2 6.5
Cost-Related Problem 6 3.5 3.5 2 5 1 7
Timeliness of Care 6 7 2 1 3 4 5
Efficiency 2 6 5 3 4 1 7
Equity 4 5 3 1 6 2 7
Long, Healthy, Productive Lives 1 2 3 4 5 6 7
Health Expenditures/Capita, 2007 $3,357 $3,895 $3,588 $3,837* $2,454 $2,992 $7,290
Country Rankings
1.00–2.33
2.34–4.66
4.67–7.00
Overall Ranking
18 3.1.2013Paulette C Compton, RN, MSN, MC

IOM 2003 Report on 5 Essential Core Competencies
for all Health Professionals Education
19

2003 IOM Health Professions Education Report
5 Core Competencies
Patient
Centered
Care
Teamwork &
Collaboration
Evidence-
based
Practice
Informatics
Quality
Improvement
20

QSEN : Quality and Safety in Nursing Education
(2004) 6 Core Competencies
Patient
Centered
Care
Teamwork &
Collaboration
Evidence-
based
Practice
Informatics
Quality
Improvement Safety
QSEN
21

What is QSEN?
 Quality and Safety Education in Nursing
 QSEN is a comprehensive website for quality and safety
education for nurses, funded by Robert Wood Johnson
Foundation
 QSEN is a faculty resource to learn and share ideas about
teaching-learning strategies, which promote quality and
safety competency development in nursing
 QSEN includes video presentations and annotated
bibliographies for faculty and nursing students to learn
about quality and safety in nursing
 www.QSEN.org SOURCE: www.QSEN.org
22

QSEN: Quality & Safety Education in Nursing
 QSEN initial goal to describe competencies which would apply to
ALL nurses & define a competent and qualified nurse.
 QSEN utilized IOM recommended 5 competencies for all health
professions AND created 2 competencies for IOM Quality
Improvement competency: Quality Improvement & Safety
 QSEN identified KSAs (Knowledge, Skills, & Attitudes) for each
competency
 QSEN competencies to serve as guide for
 Curricular development for academic programs
 Transition to practice
 Continuing education programs.
23

Massachusetts Nurse of the Future
10 Core Competency Model
Patient
Centered Care
IOM-QSEN
Teamwork &
Collaboration
IOM-QSEN
Evidence-based
Practice
IOM-QSEN
Informatics
IOM-QSEN
Quality
Improvement
IOM-QSEN
Safety
QSEN
Leadership
Mass NOF
Communication
Mass NOF
Professionalism
Mass NOF
Systems-based
Practice
Mass NOF
Source:
http://www.mass.edu/currentinit/Ni
NofCompetencies.asp

Ten Core Nursing Competencies
In 2010 publication
 Nursing Knowledge as foundation
 Communication
 Quality improvement
 Safety
 Evidence-based practice
 Patient centered care
 Leadership
 Teamwork and Collaboration
 Professionalism
 Informatics
 Systems Based Practice

Relationship/Structure of AZ
Education-Practice Collaborative Task Force
Future of Nursing, Campaign for Action
Funded by AARP & RWJF
www.campaignforaction.org
AZ Action Coalition (AC)
www.futureofnursingaz.com
AZ AC Education Task Force
is a sub-committee of AZ Action Coalition (AC)
AZ Education-Practice Collaborative Task Force
is the responsibility of AZ AC Education Task Force
27

Survey Monkey Results: #3
28

Survey Monkey Results: #5
29

What is the major impact of health care reform
on nursing education?
1) Evidence indicates the need for more educated
nurses due to the increasingly complex health care
system and improved patient outcomes, including
decreased mortality and decrease failure to
rescue, with increased percentages of BSN RNs.
IMPACT ON NURSING EDUCATION:
1) Increase pre-licensure BSN pipeline
2) Increase seamless educational progression
programs from ADN RN to BSN and/or MSN RN
3) Increase concurrent enrollment pipeline of
ADN/BSN programs
30

Nurses are the „least educated‟ healthcare profession!
Healthcare Occupations:
Minimum Education Degree for Entry to Practice
 Associate
 Registered Nurse
 Respiratory Therapist Tech
 Pharmacy Tech
 Occupational Therapy Assistants
 Physical Therapy Assistants
 Baccalaureate
 Respiratory Therapist
 Masters
 Occupational Therapist
 Social Worker
 Speech Therapist
 Counselor
 Doctoral
 Physician
 Pharmacist
 Physical Therapist
31

What is the Tri-Council for Nursing?
“The Tri-Council for Nursing is an alliance of four
autonomous nursing organizations each focused on
leadership for education, practice and research. …... These
organizations represent nurses in practice, nurse
executives and nursing educators….”
Tri-Council Member Organizations:
1) American Nurses Association
2) National League for Nursing
3) American Association of Colleges of Nursing
4) American Organization of Nurse Executives
32

2010 Policy Statement from Tri-Council
for Nursing
Educational Advancement of Registered Nurses:
A Consensus Position (cont)
Quote from 2010 Policy Statement:
“A more highly educated nursing profession
is no longer a preferred future; it is a
necessary future in order to meet the
nursing needs of the nation and to deliver
effective and safe care.”
33

„New‟ Arizona Tri-Council for Nursing
34
 Robin Schaefer, Executive Director, AZNA:
Arizona is in the process of forming a tri-council. It will be called
Arizona Tri-Council for Nursing, based on the national Tri-Council for
Nursing model with 4 organizations. The first meeting was on January
25th. The group is in the process of writing the mission and identifying
areas for collaboration.
The involved groups are:
 Arizona Nurses Association (AzNA)
 Arizona Organization of Nurse Executives (AzONE)
 Arizona League for Nursing (AzLN)
 Arizona State Board of Nursing (AZBN)

2) Evidence indicates health care reform needs to focus on
nurses (and all health professions) educational
preparation in all of the 10 Mass. Nurse of the Future
Core Competencies.
1) Need to educate nurses all of the 10 Mass NOF core
competencies
2) Need to incorporate all Mass NOF core competencies
knowledge, skills, and attitudes content in all levels of
nursing education, including RN-to-BSN
3) Proposed rule change in AZ Nurse Practice Act will
require all nursing programs to include the 6
IOM/QSEN core competencies in the curriculum.
35

2) Evidence indicates health care reform needs to
focus on nurses (and all health professions)
educational preparation in all of the 10 Mass. Nurse
of the Future Core Competencies. (continued)
4) AZ Education-Practice Collaborative Task Force
(AZEPCTF) officially affirmed the adoption of the
Mass Nurse of Future Core Competency Model and
changed the name.
36

AZ EPC Task Force Model & Purpose
On January 28, 2013 the AZ EPC Task Force
affirmed and adopted the Massachusetts Nurse of
the Future Core Competency Model and Purpose:
 Establish a formal coalition (AZ AC Education-
Practice Collaborative Task Force: AZ EPCTF) to
create a seamless progression through all levels
of nursing that is based on the evidence-based
consensus competencies of the Massachusetts
Nurse of the Future Core Competency
Model, which includes transitioning nurses into
their practice settings.
37
AZ EPCTF Meeting, Feb 22, 2013

AZ EPC Task Force Purpose
Consistent with AZ Issues/Concerns
1. Seamless progression through all levels of nursing
education (AZ- New Grad Practice Readiness)
2. Consensus on competencies to serve as a framework
for educational curriculum (AZ acceptance of AZ
Evidence-Based Massachusetts Nurse of the Future
Core Competency Model)
3. Nurse internship/preceptor program (AZ-New Grad
Practice Readiness & Nurse Residency)
38

Arizona Nurse of Future
Core Competency Model
1) DECISIONS: AZ (EPCTF) Education-Practice
Collaborative Task Force adopted the Massachusetts
Nurse of Future Core Competency Model on 1.28.13
and changed the name on 2.22.13
2) REVISED NAME:
Arizona Nurse of Future Core
Competency Model (AZ EPCTF adopted and
changed the name of the Massachusetts Nurse of
Future Core Competency Model)

Arizona Assumptions
(Adopted from Massachusetts Assumptions, 2.22.13)
1) Education and Practice partnerships are key to
developing an effective model.
– Nursing education and practice setting should facilitate individuals
to move more effectively move through the educational system.
– An integrated practice/education competency model will positively
impact patient safety and improve patient care.
– Nursing practice should be differentiated according to the
registered nurse‟s educational preparation and the level of practice
and further defined by the role of the nurse and the work setting
– Practice environments that support and enhance professional
competence are essential.
40

Arizona Assumptions
2) It is imperative that leaders in nursing education
and practice develop collaborative curriculum
models to facilitate the achievement of a minimum
of a baccalaureate degree in nursing (BSN) by all
nurses.
– Advancing the education of all nurses is increasingly being
recognized as essential to the future of nursing practice.
– Evidence has demonstrated that nurses with higher education levels
have a positive impact on patient care.
*Please note this assumption does NOT state „BSN minimal entry into
practice‟ but means the goal is for all RNs, including Diploma &
Associate RNs, to achieve BSN through collaborative curriculum
models.
41

Arizona Assumptions
3) There is a need to develop a more effective
educational system that is capable of incorporating
the shifting demographics in order to prepare the
nursing workforce to respond to current and future
health care needs and population health issues.
– The competencies are designed to be applicable across
all care settings and to encompass all patient
populations across the lifespan.
– In this global society, essential to the care of diverse
populations is the need for evidence-based knowledge
and sensitivity to variables such as
age, gender, culture, health disparities, socioeconomic
status, race, and spirituality.
42

Arizona Assumptions
4) The nurse of the future will be proficient at a core
set of competencies.
– There is a differentiation in competencies among practicing nurses
at various levels.
– Competence is developed over a continuum and can be measured
5) Nurse educators in both education and practice
settings will need to use a different set of
knowledge and teaching strategies to effectively
integrate the Nurse of the Future competencies
into curriculum.
43

Additional Arizona Assumption
Approved
6) As nurses and patient advocates, the AZ EPC
Task Force supports the need for increased
education for all nurses because with increasingly
complex health care, the patient requires a more
educated nurse in order to deliver effective and safe
care.
The Massachusetts NOF assumptions and the above
additional assumption were adopted by the AZ
EPCTF on Feb 22, 2013.
44

AZ Nurse of the Future: Core Nursing Competencies
These competencies are the expectations for all
professional nurses of the future.
The Knowledge, Attitude and Skills (KAS)
grids are the minimal expectations for initial
nursing practice following completion of any pre-
licensure professional nursing educational
program.

What were the professional standards used for the framework
of Nurse of the Future Core Competencies
 ACGME
 AHRQ
 AACN
 ANA
 AONE
 Bologna Accord
 CCNE
 COPA
 IOM
 ICN
 NCSBN
 NLN
 NLNAC
 QSEN
See page 42, NOF Core Competencies

Knowledge Attitudes/behaviors Skills
Describes the
nursing context for
improving care
Recognizes that quality
improvement is an
important part of being a
nurse.
Actively seeks information about quality improvement
from relevant institutional, regulatory and local/national
sources.
Understands that the
nurse and care
delivered is part of a
broader health care
system.
Recognizes that
interdependent
relationships and a
professional work
process are important to
quality improvement.
Participates in the use of quality improvement tools
(such as flow charts, cause & effect diagrams) to make
processes of care interdependent and explicit
Explains the
importance of
variation and
measurement in
providing quality
nursing care.
Appreciates how
unwanted variation
affects care and how
standardization can
support quality patient
care.
Participates in the use of quality measures (such as
control and run charts) to assess performance and
identify gaps between local and best practices.
Describes
approaches for
changing processes
of care in which the
learner is involved.
Recognizes the value of
what individuals and
teams can do to improve
care.
Participates in the use of measures to evaluate the effect
of changes in the delivery of care.
Quality Improvement
The Nurse of the Future will use data to monitor outcomes and care processes, and use
improvement methods to design and test changes to continuously improve the quality
and safety of healthcare.

Core Competency Comparisons
Source: Maureen Sroczynski
IOM ACGME QSEN NOF
Apply Quality
Improvement
Practice based
Learning
& Improvement
Systems Based
Practice
Quality
Improve-
ment
Safety
Quality Improvement
Safety
Systems based practice
Provide
Patient-
Centered Care
Patient Care
Interpersonal &
Communication
Skills
Patient
Centered
Care
Patient Centered Care
Communication
Leadership
Work in
Inter-
Disciplinary
Teams
Professionalism Teamwork
and
Collaboration
Teamwork and Collaboration
Professionalism
Employ
Evidenced-
Based
Practice
Medical Knowledge Evidence
based
practice
Evidence based practice
Utilize
Informatics
Informatics Informatics

NOF
 Professionalism
 Evidence-based practice
 Nursing knowledge
 Informatics
AACN. (2008). Essentials of
Baccalaureate Education for
Professional Nursing Practice
(adopted by AACN 10/28/08)
 Professionalism & Professional
Values
 Scholarship for evidence-based
practice
 Liberal Education & Discipline of
Nursing
 Information Literacy &
Information Management and
Patient Care Technology

promotion of wellness in the community and decreased
hospital admissions.
1) Need to educate nurses on the role of „the nurse coach,‟
which will be a new important role in health care
2) Need to educate nurses on „motivational
counseling/interviewing.‟
3) Need to have increased clinical experiences in „the
community with health promotion‟ rather than
treatment focus in acute care
50

focus on management of multiple chronic illnesses.
1) Need to educate nurses on the role of management
of multiple chronic illnesses.
2) Need to educate nurses on „motivational
counseling/interviewing.‟
3) Need to have increased clinical experiences in „the
community‟ with focus on management of multiple
chronic illnesses
51

safety and quality improvement
1) Need to educate nurses about quality improvement
processes, including root cause analysis, near misses,
system-based practice to prevent avoidable medical
errors
2) Evidence indicates new RN grads have not been taught
about quality improvement
3) Evidence indicates harm rates continue to be about
same level as 1999 IOM To Err is Human data.
4) New role „Nurse patient safety officer‟
52

Evidence New Grad Knowledge Gaps in Quality
Improvement Education
Kovner, C.T., et al. (2010) New Nurses‟ Views of Quality
Improvement Education. The Joint Commission Journal on
Quality and Patient Safety. 36(1), 29-35.
STUDY RESULTS: N=436 (38.6%) newly licensed RNs thought
they were “poorly” or “very poorly” prepared about or had
“never heard of QI.” BSN grads reported significantly higher
levels of preparation in EBP, evidenced-based practice;
assessing gaps in practice, teamwork, collaboration; and many
research skills.
STUDY CONCLUSIONS: RN educational programs need to
improve education about and application of QI concepts and
to consider focusing QI content into a separate course to
assure it is taught.
53

focus on evidence-based practice
1) Need to educate nurses about evidence-base
practice
2) Need to increase EBP curriculum content in all
levels of nursing education
3) Evidence indicates new RN grads have not been
adequately taught about evidence-base practice
54

Evidence New Grad Knowledge Gaps in EBP &
Quality Improvement Education
Sullivan, D. T., et al. (2009). Assessing quality and safety competencies
of graduating prelicensure nursing students. Nursing Outlook.
57, 323-331.
STUDY RESULTS: N= 565. Only 49% newly licensed RNs reported
curriculum included reliable resources for locating evidence-based
reports and clinical guidelines. Students believed they were most
prepared to perform skills in core competencies patient-centered
care & informatics. Students felt least prepared for skills in
evidenced-based practice & quality improvement tools and
evaluating the effects of practice changes.
STUDY CONCLUSIONS:
Due to gaps between theoretical presentation of quality and safety
information and demonstrated application in practice, need to focus
on redesign of curriculum content to include quality and safety
education/practices. Special attention is needed to develop student
competency in quality improvement.
Paulette C Compton, RN, MSN, MC
55
3.1.2013

7) Evidence indicates health care reform needs to focus
on improving health literacy.
1) Need to educate nurses about health literacy
2) Need to increase health literacy curriculum content
in all levels of nursing education
3) Evidence indicates new RN grads need health
literacy evidence-based practice interventions to
improve health literacy and decrease avoidable
medical errors resulting from poor health literacy.
56

What is the major impact of health care reform on
nursing education?
focus on high incidence with high
mortality/morbidity management of chronic
illnesses.
Need to educate nurses on evidence-base treatment for 20 priority
areas for curricular content (2003 IOM Report-Priority Areas for
National Action: Transforming Health Care)
Based on: A) Impact or extent of burden
B) Improvability or gap between
current practice and evidence-based practice
C) Inclusiveness or relevance of an
area to broad range of individuals
57

nursing education?
Need to educate nurses on evidence-based treatment for 20
priority areas for curricular content (2003 IOM Report-
Priority Areas for National Action: Transforming Health
Care)
Areas in most need of improvement in nursing curriculums in
red font
1) Care coordination
2) Self-Management & health literacy
3) Asthma
4) Cancer screening evidence-based, focus on colorectal
and cervical
58

nursing education?
5) Children with special health care needs
6) Diabetes
7) End of life care with advanced system failure
8) Frailty associated with old age
9) Hypertension
10) Immunizations
11) Ischemic heart disease
12) Major depression screening and treatment
59

nursing education?
13) Medical management: Preventing medication
errors and overuse of antibiotics
14) Nosocomial infections
15) Pain control
16) Pregnancy and childbirth
17) Severe and persistent mental illness
18) Stroke
19) Tobacco dependence
20) Obesity
60

nursing education?
9) Need for nurse clinicians who are also experts in how to
implement technology to improve patient care quality
1) Need to educate nurses to assume roles of
A) Chief nursing informatics officer
B) Chief nursing clinical informatics officer
2) Advanced practice degree in informatics and certification
in clinical informatics
61

nursing education?
10) Need for nurse clinicians who are also experts in how to
coordinate care
1) Need to educate nurses to assume roles of
A) Care coordinator
B) Nurse Navigator
2) VA „Nurse navigator role‟ uses VA Nurse-Patient Shared
Decision Support Tool
(Source: Holtz,B. et al (2013) A Nurse-Patient Shared Decision Support
Tool. AJN(113)1.
62

SUMMARY: 10 Selected Major Impacts of Health
Care Reform on Nursing Education
63
 10 selected impacts identified; not comprehensive
Check out ANA resources on Health Care Reform:
http://nursingworld.org/MainMenuCategories/Policy-
Advocacy/HealthSystemReform
 Significant need for advanced practice primary care nurse
practitioners not included in presentation
 Collaboration between nursing education and nursing
practice essential to improve new grad practice readiness to
meet the quality and safety needs of patients and families
 If you are interested in volunteering to work on AZ
Education-Practice Collaborative Task Force, email me:
Paulette.Compton@bannerhealth.com

DropBox
64
 DropBox „link‟ to access AZ Education-Practice
Collaborative Task Force docs:
https://www.dropbox.com/sh/79qvd8u71awjjd4/yebF
UkJjlh

Questions/Comments
65

Healing community pp, 3.1.13

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