Arizona Action Coalition

The Arizona Action Coalition was established in March 2012 to guide the implementation of the recommendations of the Institute of Medicine's Future of Nursing Report.

8 Recommendations of The Future of Nursing: Leading Change, Advancing Health

In 2008, The Robert Wood Johnson Foundation (RWJF) and the Institute of Medicine (IOM) launched a two-year initiative to respond to the need to assess and transform the nursing profession. The IOM appointed the Committee on the RWJF Initiative on the Future of Nursing, at the IOM, with the purpose of producing a report that would make recommendations for an action-oriented blueprint for the future of nursing.

Recommendations:

  • Recommendation 1: Remove scope-of-practice barriers.
  • Recommendation 2: Expand opportunities for nurses to lead and diffuse collabora¬tive improvement efforts.
  • Recommendation 3: Implement nurse residency programs.
  • Recommendation 4: Increase the proportion of nurses with a baccalaureate degree to 80 percent by 2020.
  • Recommendation 5: Double the number of nurses with a doctorate by 2020.
  • Recommendation 6: Ensure that nurses engage in lifelong learning.
  • Recommendation 7: Prepare and enable nurses to lead change to advance health.
  • Recommendation 8: Build an infrastructure for the collection and analysis of inter¬-professional health care workforce data.

For more information visit www.campaignforaction.org/issues


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Arizona Action Coalition (established March 2012)

  • The purpose of the Arizona Action Coalition is to guide implementation of the recommendations from the Institute of Medicine’s (IOM) Future of Nursing report in Arizona.
  • The IOM report provides a blueprint for transforming the nursing profession to improve health care and meet needs of diverse populations.
  • The Arizona Action Coalition (AZAC) has been working with the Center to Champion Nursing in America (CCNA) to address challenges facing nursing. CCNA is a partnership between the Robert Wood Johnson Foundation (RWJF), and AARP.

Key messages from the Future of Nursing report:

  • Nurses should practice to the full extent of their education and training.
  • Nurses should achieve higher levels of education and training through an improved educational system that promotes seamless academic progression.
  • Nurses should be full partners, with physicians and other health professionals, in redesigning health care in the United States.
  • Efficient workforce planning and policy making require better data collection and an improved information infrastructure.

Brief Overview of Action Coalitions

  • Driving force of the Future of Nursing: Campaign for Action, a collaboration through AARP, AARP Foundation, CCNA and RWJF.
  • Supporting a health care system where all Americans have access to high-quality care, with nurses contributing to the full extent of their capabilities.

Action Coalitions are built to:

  • Effect long-term sustainable change at the local, state and regional levels
  • Capture best practices, determine research needs, track lessons learned and identify replicable models
  • Implement recommendations from the IOM report
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Transforming Arizona to a Culture of Health: Leveraging Wisdom of the Nurse

RWJF Vision We, as a nation, will strive together to build a Culture of Health enabling all in our diverse society to lead healthy lives, now and for generations to come

Nurses Crucial to Building a Culture of Health

Nurses make up the largest segment of the health and health care workforce and spend most time with people.

WE:

  • Promote prevention and wellness
  • Provide population-focused services to entire communities
  • Manage influx of older, sicker and newly insured patients
  • Develop new models of care
  • Provide care coordination
  • Help hospitals to reduce medical errors and re-hospitalizations

Campaign Vision

Everyone in America can live a healthier life, supported by a system in which nurses are essential partners in providing care and promoting health

Public Health Nurses (PHNs)

  • A shortage of nurses, primarily in rural areas with a preparation of public health nursing
  • An aging public health nursing workforce competing with acute care settings (higher salaries)
  • A shortage of clinical placement sites during education
  • An absence of a standardized public health nursing orientation/mentorship for assurance of competency-based practice
  • Need for outcomes data to demonstrate value of nurse in community/public health settings
  • Professional Development (Formal and/or continuing education plan): Educational progression,  Standardized Orientation, Mentorship/Coach, Internship
  • Partnership Development: Arizona Health Education Center, School Nurses
  • Communication/connections to existing nursing infrastructure: AZ Action Coalition Collaboratives: Leadership, Education-Practice

 

Public Health Nurses promoting a Culture of Health

  • Library Public Health Nurse to improve the physical and mental health of library patrons through education, referral, crisis prevention, nursing intervention, and disease management nursing care models.
  • Mohave County Department of Public Health School Immunization Assessment

School Nurses promoting a Culture of Health

  • Provide health services that increase school attendance
  • Prevent and control the spread of communicable disease
  • Administer specialized services to students(medications, insulin pumps, ventilators, tube feedings)
  • Conduct screenings and make referrals for vision, hearing, BMI, etc.
  • Provide health professional input and direction for school and community policies and programs
  • Educate students and staff on managing their own health and wellness
  • Verification of immunizations and increase in immunization compliance
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Goal: Achieve 80% BSN by 2020 and double the number of doctorates

In 2015 the percent of nurses with bachelors degrees or higher increased from 46% in 2011 to 60% in 2015. (14% increase) The majority community college nursing programs offer concurrent enrollment programs (CEP) with one or more BSN Program (new programs include Central Arizona College and Arizona Western College) Nearly half of nursing students in MaricopaNursing programs are enrolled in the CEP

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EPC is a collaborative group of over 165 Arizona nurses from education and practice. It currently consists of representatives from 18 clinical agencies and 20 pre-licensure RN nursing programs. This collaboration between nursing education and nursing practice is essential to improve practice readiness and increased competence of Registered Nurses to meet the quality and safety needs of patients and families.

2015 Initiatives

  • Reignite, Reenergize, and Reinvest the EPC volunteers
  • Recognize the contributions of the small group work and build a sustainable infrastructure to maintain forward movement
  • Establish a quarterly meetings with practice/academic stakeholders
  • Identify exemplars of integration of NOF competencies as a conceptual framework in practice/academic educational programs
  • Assess degree completion in Arizona to determine alignment with doubling the number of nurses with a doctorate degree by 2020
  • Discuss strategies for Education/Practice collaboration for design and development of nurse residency programs

2016 Initiatives

  • Continue small work groups to develop a competency-based curriculum delivery across practice and academic settings
  • Build on the Massachusetts Action Coalition toolbox for effective teaching strategies to prepare the emerging nursing workforce with identified competencies
  • Actualizing the Transition to Professional Practice Nurse Residency Model across all practice and academic settings to provide a seamless transition for program participants
  • Exploring statewide certification for the program through accrediting bodies

The Intentional Nurse

Goal of Statewide Nurse Residency Program: To promote safe quality patient care by providing best-practice approaches to onboarding new nurses to the practice arena.

  • Objective 1: Provide a seamless transition to professional practice environment supported by academia, practice and regulation.
  • Objective 2: Empower the emerging workforce with intellectual and organizational competence to deliver safe quality patient care.
  • Objective 3: Capture return of investment: increased retention, increased employee satisfaction, increased confidence and competence, and fiscal outcomes.

Link to a Culture of Health

  • Prepare nurses to think “outside the acute care walls”
  • Relate the culture of health to professional identity
  • Expand RN capability and capacity to increase access to care, collaborate with communities and health departments, increase volunteerism, prevent readmissions, and demonstrate performance based outcomes
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Roadmap to Legislative Success: Practice Focus

Recommendation 1: Remove scope-of-practice barriers.

The Consensus Model for APRN Regulation: Licensure, Accreditation, Certification & Education (LACE)

Full Practice Authority:

  • CNP - Certified Nurse Practitioner
  • CRNA - Certified Registered Nurse Anesthetist
  • CNM - Certified Nurse Midwife
  • CNS - Certified Nurse Specialist

Each state must pass their own legislation

The goal of this legislation is to allow Advanced Practice Nurses to practice to the full extent of their education and training, which will increase patient accessibility of safe, cost-effective care.

Summary:

In 2017, two Arizona bills were signed into law;

  • SB1133 (Certified Nurse midwives; nurse practitioners)
  • SB1336 (nurse anesthetists; prescribing authority; limtation).

Legislation for CNSs is anticipated for the 2019 Arizona legislative session.

For a detailed look at the process required to get this legislation passed, please visit the AzNA website's Top Issues page.

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History

Purpose:

  • Support the IOM 2010 Report, The Future of Nursing: Leading Change, Advancing Health
  • Prepare and enable nurses to lead change to advance health

Arizona Action Coalition Work:

  • Our Focus: Expand nursing leadership opportunities for participation in board rooms, policy discussions and on management teams
  • Develop strategies to support nurse leaders to develop skills to serve on hospital and statewide governing boards
  • Part of National Strategy – Nurses on Boards Coalition “Leap Into Leadership” Toolkit & Resources

Leadership in Action Awards

Recommendation #2: Expand opportunities for nurses to lead and diffuse collaborative improvement efforts

Aim

To recognize nurse leaders within Arizona:

  • 2014 - Four recipients recognized
  • 2015 - Five recipients recognized
  • 2016 - 4 recipients recognized
  • Awards are given at Adda Alexnder Conference, awardess receive free event registration

Many nurses do not think of themselves as leaders, yet they are making a significant contribution as a professional nurse in various settings across our state, from rural or reservation care sites, to academia, healthcare facilities and multiple agencies and settings across our communities.

Nurses on Boards Task Force

Recommendation #7: Prepare and enable nurses to lead change to advance health.

2014 Survey Results

The Data:

  • 4,344 Respondents
  • 250 Nurses serving on a healthcare board

Interested in Getting Prepared to Serve on a Board:

  • 2, 669 Respondents
  • Identify Board to serve on
  • Learn more about it
  • Want training
  • Want mentoring

Goals

Communications & Metrics

  • Collect & share NOB data
  • Set goal for Arizona
  • Develop process to measure progress and success

Nurses on Boards Educational Opportunity

  • Core competencies
  • Program Options: One Day Face to Face, Series Webinars
  • Timeline
  • Funding

Mentoring Program

  • Develop criteria for mentorship
  • Identify potential mentors
  • Develop process for mentoring

Board Referral Program

  • Refer Qualified Nurses to Boards with Open Positions
  • Work with businesses to promote competent nurse candidates
  • Assist candidates in board.
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IOM Recommendation 8

Effective workforce planning and policy making require better data collection and an improved information infrastructure.

  • To respond to a diverse demographic, an aging population, and current and expected economic conditions that affect utilization of health care services
  • To timely adapt to opportunities for professional education and training resulting from emerging technology
  • To meet the demand of all types of healthcare workers for Arizona’s future healthcare system needs.

Robert Wood Johnson Foundation SIP3 Grant

February 1, 2015 to January 1, 2017

  • Develop a sustainable model and health professions data system for Arizona, to collect and disseminate timely and reliable data for workforce planning and decision-making
  • Data would be accessible to many groups, including but not limited to: employers, educational institutions, business community, researchers, funders, state-based organizations, professional organizations and policy-makers.

For in-depth Grant information please visit:

Grant Overview

Workforce Plan

Additional Information

Arizona Resources & Data

National Resources & Data

Helpful Links

National Forum of State Nursing Workforce Centers

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First Diversity Project

  • Prepare a diverse RN workforce by providing mentorship opportunities for nursing students from diverse backgrounds to engage in mentored clinical experiences with underserved populations and communities
  • Identify mentors—at least 20 (NAHN, Philippine Nurses Association, Black Nurses Association)
  • Focus on underserved populations
  • Mentor training—using storytelling with structure
  • Engage students
  • Pair diverse mentors with students from BNF program at SMCC and PC

Progress - April 2016

  • Four mentor workshops held; 1 mentee workshop held
  • Framework of “Storytelling” and archetypes utilized for mentors to learn to tell their own story and understand the stories of mentees
  • Self development of the mentor was the focus with various tools for analysis of personality and archetypes.
  • Overwhelming positive evaluations—little attrition
  • Mentors and mentees work together to complete a community service project with diverse cultures/population
  • Mentees due to graduate this Spring

Next Steps

  • Increase diversity with more schools and diversity (ASU, American Indian population)
  • Recruit 40 mentor/mentee pairs
  • Revise workshops and schedules to account for unavoidable absences
  • Explore distance technology for mentor training.

Second Diversity Project: Culturally relevant ACA education

Build upon existing NAHN Leadership Training for nurses and students, teaching Arizona multicultural communities the fundamentals of the Affordable Care Act or other community heath projects

  • Train the trainer
  • Culturally appropriate messages
  • State-wide partnerships
  • Face-to-face mentor meetings
  • Evaluate, track, report

Project Implementation

  • Train the trainer sessions have been held
  • Phoenix Chapter NAHN has been selected is in their 2nd year of educate and support multicultural individuals and families, particularly Latinos, regarding the fundamentals of the ACA and assisting them through the process of attaining health care coverage