Transcript Kentucky Nursing Capacity Consortium Update

Kim Dees, MSN, RN, MBA/HCM
Kentucky Hospital Association
Vice President of Health Professions
Sherry Holmes, MSN, RN
University of Kentucky College of Nursing
Coordinator of Assessments and Special Projects
Kentucky Organization of Nurse Leaders 8th Annual Conference
September 21, 2012 Louisville , Kentucky
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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
1. Remove scope-of-practice barriers
2. Expand opportunities for nurses to lead and diffuse
collaborative improvement efforts
3. Implement nurse residency programs
4. Increase the proportion of nurses with a baccalaureate
degree to 80% in 2020
5. Double the number of nurses with a doctorate by 2020
6. Ensure that nurses engage in lifelong learning
7. Prepare and enable nurses to lead change to advance
health
8. Build an infrastructure for the collection and analysis
of interprofessional health care workforce data

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

Short term goal - position KYAC to achieve longterm 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

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
 Barriers
 80%
to APRN Practice
BSN by 2020
Barriers to APRN Practice

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

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)

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

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
80% BSN by 2020
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US
Kentucky
% ADN
% BSN
% MSN/
Doctorate
Est. #
%
Diploma
KY Est. #
KY Est. #
2,596,59
9
12.1%
37.6%
37.3%
13.0%
41,520
-
54.1%
22,475
29.8%
12,354
11.4%
4,748
KY Est. #
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Diploma
Nsg/RN
Associate
Degree/Nsg
Associate
Degree/NonNsg Field
Baccalaureate/
Nsg
Baccalaureate/
Non-Nsg Field
2927
31289
46
18559
1867
Masters/Nsg
Masters/
Non-Nsg Field
5823
1254
Doctorate/Nsg
266
Doctorate/
Non-Nsg Field
220
Kentucky Board of Nursing RN Current Licensure Count - By Educ. Level & County of Residence
http://www.kbn.ky.gov/stats

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

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 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

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

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)

Commit to take action on recommendations
from IOM report, this is about patientcentered 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

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
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