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The future of nursing report Oklahoma initiatives: based on joint meeting of IONE, OONE, ONA, OK Board of Nursing and OK Health Care Workforce Center--December 2010.

KEY MESSAGES--from IOM Report on the Future of Nursing

As a result of its deliberations, the IOM committee formulated four key messages that structure the discussion and recommendations presented in this 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.

3. Nurses should be full partners, with physicians and other health professionals, in redesigning health care in the United States.

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

RECOMMENDATIONS--From IOM Report on the Future of Nursing Oklahoma's ongoing work pertinent to the recommendations

IOM Recommendation 1: Remove scope-of-practice barriers. Advanced practice registered nurses should be able to practice to the full extent of their education and training.

Board of Nursing has been reviewing the Consensus Model for APRN Regulation and has issued a report based on the work of the APRN Task Force. In 2011 the Board introduced HB 1275 that by creates a separate licensure for Advance Practice Registered Nurses, changes title from APN to APRN aligning Advance Practice in Oklahoma with the Consensus Model.

The Oklahoma Nurses Association has been in support of APRN's working at the top of their license. ONA has joined the Coalition for Patients Rights (CPR) Nationally, ANA is a founding member of this organization. CPR, consisting of more than 35 organizations representing a variety of licensed healthcare professionals It was formed to address scope of practice barriers and ensure that patients have direct access to the full scope of services offered by the quality health care providers of their choice.

IOM Recommendation 2: Expand opportunities for nurses to lead and diffuse collaborative improvement efforts. Private and public funders, health care organizations, nursing education programs, and nursing associations should expand opportunities for nurses to lead and manage collaborative efforts with physicians and other members of the health care team to conduct research and to redesign and improve practice environments and health systems. These entities should also provide opportunities for nurses to diffuse successful practices.
 ONA is also involved with working collaboratively
 with other providers and health care entities
 at the State Capitol ONA is involved with state
 wide groups such as the Electronic Health
 Record Consortium and a group focused on
 Health Insurance Exchange Other examples
 of collaborative work include: Joanna Briggs
 Institute of Oklahoma, NDNQI Collaborative and
 Oklahoma Health Care Workforce Center.

IOM Recommendation 3: Implement nurse residency programs. State boards of nursing, accrediting bodies, the federal government, and health care organizations should take actions to support nurses' completion of a transition-to-practice program (nurse residency) after they have completed a prelicensure or advanced practice degree program or when they are transitioning into new clinical practice areas.
 ONA recognizes that well designed mentoring
 programs support the growth and development
 of novice nurses in their transition to professional
 practice and provide opportunities for leadership
 development ONA has adopted a position on
 Nurse Residency Programs and the transition
 of novice nurses to the workplace The ONA
 Committee on Professional Practice in the
 workplace has established a task force on Nurse
 Residency The focus of this task force has been
 to review what currently exists in Oklahoma and
 ways to create a state system.

IOM Recommendation 4: Increase the proportion of nurses with a baccalaureate degree to 80 percent by 2020. Academic nurse leaders across all schools of nursing should work together to increase the proportion of nurses with a baccalaureate degree from 50 to 80 percent by 2020. These leaders should partner with education accrediting bodies, private and public funders, and employers to ensure funding, monitor progress, and increase the diversity of students to create a workforce prepared to meet the demands of diverse populations across the lifespan.
 The 2009 ONA House of Delegates adopted
 a resolution supporting initiatives to require
 registered nurses (RNs) to obtain a baccalaureate
 degree in nursing within ten years after initial
 licensure. It exempts (or "grand-parents") those
 individuals who are licensed or are enrolled as
 a student in a nursing program at the time state
 legislation is enacted.

IOM Recommendation 5: Double the number of nurses with a doctorate by 2020. Schools of nursing, with support from private and public funders, academic administrators and university trustees, and accrediting bodies, should double the number of nurses with a doctorate by 2020 to add to the cadre of nurse faculty and researchers, with attention to increasing diversity.
 Oklahoma now has two universities providing
 Nursing Doctorates--Oklahoma City University.
 Kramer School or Nursing and University of
 Oklahoma, College of Nursing

IOM Recommendation 6: Ensure that nurses engage in lifelong learning. Accrediting bodies, schools of nursing, health care organizations, and continuing competency educators from multiple health professions should collaborate to ensure that nurses and nursing students and faculty continue their education and engage in lifelong learning to gain the competencies needed to provide care for diverse populations across the lifespan.

The Oklahoma Board of Nursing is in the process of adding language in Rules for continued competency requirements in section 485:10-7-3 [485:10-9-3] for the renewal of a nursing license to be effective January 1, 2014 Each licensee will be required to demonstrate evidence of continuing qualifications for practice through the completion of one or more requirements within the past two years prior to the expiration date of the license. If audited, the licensee must present documentation supporting the continuing qualifications The continued competency requirements are:

(1) Verify employment in a position that requires a registered nurse [practical nurse] with verification of at least 520 work hours; or

(2) Verify the completion of at least twenty-four (24) contact hours of continuing education applicable to nursing practice; or

(3) Verify current certification in a nursing specialty area; or

(4) Verify completion of a Board-approved refresher course; or

(5) Verify completion of at least six (6) academic semester credit hours of nursing coursework at the licensee's current level of licensure or higher.

IOM Recommendation 7: Prepare and enable nurses to lead change to advance health. Nurses, nursing education programs, and nursing associations should prepare the nursing workforce to assume leadership positions across all levels, while public, private, and governmental health care decision makers should ensure that leadership positions are available to and filled by nurses.
 ONA and ANA empower nurses to be competent
 professional leaders in health care Leadership is
 intrinsic to the profession and has been a formal
 professional standard of nursing practice in both
 the professional practice setting and within the
 profession for nearly two decades. (Nursing:
 Scope and Standards of Practice, 2nd Ed.,
 Standard 12. Leadership, p.55).

 ONA policy is member driven ONA, OONE,
 IONE and OHCWC provide leadership
 development and mentoring programs.

 ONA and OONE have long worked to identify
 nurse leaders to serve on a wide variety of public
 and private boards and advisory bodies.

IOM Recommendation 8: Build an infrastructure for the collection and analysis of interprofessional health care workforce data. The National Health Care Workforce Commission, with oversight from the Government Accountability Office and the Health Resources and Services Administration, should lead a collaborative effort to improve research and the collection and analysis of data on health care workforce requirements. The Workforce Commission and the Health Resources and Services Administration should collaborate with state licensing boards, state nursing workforce centers, and the Department of Labor in this effort to ensure that the data are timely and publicly accessible.
 The Oklahoma Health Care Workforce Center
 participates in the Forum of State Nursing
 Workforce Centers, which is a group of nurse
 workforce entities who focus on addressing
 the nursing shortage within their state The
 workforce center has an established Data
 Committee and has been working on this issue
 with all the health related licensing boards.

Sources and More Information Available Online

American Nurses Association:

Institute of Medicine: h t t p : / / .aspx

Robert Wood Johnson Foundation: http://www.rwjforg/

The Future of Nursing Website:

Coalition for Patients Rights:

Submitted by Jane Nelson, CAE, ONA Executive Director
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Author:Nelson, Jane
Publication:Oklahoma Nurse
Date:Jun 1, 2011
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