By Heather Stringer
The year 2015 marks an important half-way point for the ambitious goals set forth in 2010 in the Institute of Medicine’s Future of Nursing Report, which included eight recommendations to transform the nursing profession.
Recommendation 6 calls for the profession to ensure nurses engage in lifelong learning, and to accomplish this goal a diverse collective of groups should collaborate — including accrediting bodies, schools of nursing, healthcare organizations and continuing competency educators.
“In today’s rapidly evolving healthcare environment, nurses cannot go to nursing school and call it a day as far as education [is concerned],” said Sue Hassmiller, PhD, RN, FAAN, senior adviser for nursing at the Robert Wood Johnson Foundation, Princeton, N.J. “They need to continue their education and clinical competency, especially since nurses are needed who can practice not only in the acute care setting, but across the entire continuum of care.”
While this recommendation may not have specific percentages to gauge progress like other recommendations, there are clear signs that the IOM report is motivating organizations to prioritize learning for employees who are in various stages of the educational process, Hassmiller said.
ANCC standards established
In October 2014, for example, the American Nurses Credentialing Center launched standards for credentialing nurse residency and fellowship programs. These hospital programs transition nurses from their academic programs to the clinical setting, or in some cases between different types of clinical settings. The participants in residencies and fellowships include new graduates, nurses changing careers within the practice setting and advanced practice nurses.
“Historically the quality of the residencies and fellowships have varied quite a bit,” said Kathy Chappell, PhD, RN, vice president of the ANCC Accreditation Program and the Institute for Credentialing Research. “These programs could be as short as eight weeks or as long as a year. In general, a prolonged and concentrated residency or fellowship should be at least six months and sometimes up to a year in length.”
To have their residency or fellowship programs accredited, hospitals now are required to meet criteria in areas such as preceptor training, measurable quality outcomes and qualifications of the people who are developing and teaching the programs. So far four residency and fellowship programs have been accredited in the country, and Chappell expects an increase in applications within the next five years.
“I suspect many organizations are doing self-assessments to see if they meet the standards, and the application may be a template for a gap analysis,” she said. “They will address those gap areas before applying.”
Recommendation 6 also mandates healthcare organizations provide resources for interprofessional continuing education, which means nurses have the opportunity to learn collaboratively with other health professionals. In 2010 the ANCC — in collaboration with accreditor colleagues from medicine and pharmacy — began credentialing organizations providing interprofessional continuing education in nursing, medicine and pharmacy. Chappell has seen a significant increase in applications for this type of credentialing since the IOM report was released in 2010. There are 18 credentialed organizations, and she expects that number to double by the end of this year.
The lifelong learning described in Recommendation 6 not only applies to clinical skills, but also to leadership skills, Hassmiller said. To provide more leadership education for nurses, organizations such as the American Academy of Nursing have launched new programs including the Academy’s Institute of Nursing Leadership. This program, which began in fall 2014, helps nurses to obtain and be effective in gubernatorial and federal appointments, and also while serving on governing boards of national health and social organizations.
“These are the thought leaders of nursing, and it is easy to think they are already developed as leaders, but they could benefit from more learning about political appointments,” said Diana Mason, PhD, RN, FAAN, president of the American Academy of Nursing.
The need for this type of training was highlighted for Mason when she recently worked with a nurse who was interested in pursuing an appointment on a federal commission. The nurse was a Republican, however, and lacked the connections within political circles to secure a letter of support from a Democrat to demonstrate she was bipartisan and could bring an important perspective, Mason said.
“Governors make 200 to 300 appointments, and we realized that few organizations were focused on preparing nurses at the state and federal tables,” Mason said.
Although employers and nurses will likely face the traditional challenges of finding time and money to pursue lifelong learning, nurse leaders like Pat Polansky believe RNs today have one significant advantage over their predecessors: technology. “Due to online learning, there is more access to lifelong learning that is compatible with our lives than ever before,” said Polansky, MS, RN, director of program development and implementation at the Center to Champion Nursing in America. “When I was practicing I used to find a babysitter to participate in a continuing education course taught on a weekend or evening in a classroom. Now nurses can watch webinars, live streaming and log in anytime in their own homes. Online learning is a game-changing piece when it comes to keeping nurses current.”
The increase in accessibility and interest in online education in recent years is making a difference in patient care, said Joyce Batcheller, DNP, RN, NEA-BC, FAAN, senior vice president and CNO of Seton Healthcare Network in Austin, Texas.
“I saw nurses talking about what they were learning online and coming up with ideas based on what they had been taught,” Batcheller said. “I also saw the impact in the interprofessional setting because there was a lot more dialogue between nurses and physicians. Everyone brings their professional insights and the patients end up winning.”
Heather Stringer is a freelance writer.
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