February 24, 2000

To: Helene Fuld Health Trust

Attention: Jina Paik

Re: Grant # 98040--Enhanced Educational Mobility for Nurses in California (California Strategic Planning Committee for Nursing (CSPCN) - Final Report

On behalf of the nurse leaders in California, I would like to thank you and the Helene Fuld Health Trust for supporting the work of the California Strategic Planning Committee for Nursing. This report represents the final report on our work to enhance education mobility for nurses in California.

Project Objectives:

  1. Integrate differentiated practice competencies into an articulated nursing education model.
  2. Identify the curricula for LVN, ADN, BSN and MSN practice.
  3. Create a seamless articulation plan among the nursing education programs.
  4. Promote involvement of nurse educators, administrators and employers of nurses in defining and supporting educational mobility within a statewide, articulated nursing education system.

Major tasks accomplished to meet the above objectives:

  1. A design of statewide educational mobility workshops to address the project objectives. The workshops were held in the northern and southern regions of the state—April 26-27, 1999, in Sacramento, and May 3-4, 1999, in Los Angeles. Seventy-five nurse educators, nursing employers, and nursing students participated in these workshops. The following tasks were accomplished:
  2. a) Literature review on educational mobility and articulation issues was undertaken. Relevant articles were summarized or annotated for participants attending the workshops. Project team members sought consultation from other states and programs that have implemented educational mobility projects. Models from various programs were incorporated into a presentation for the workshops.

    b) Project staff solicited nominees for workshop participants, from LVN, ADN and BSN nursing directors, and from major nursing service systems. We received excellent and enthusiastic responses. This allowed us to invite a diverse group with various levels of expertise in educational mobility issues.

    c) All California nursing programs were asked to complete a survey related to current mobility and articulation practices. These data were summarized for the workshop participants.

    d) Nancy Stuever, was sent to an articulation conference held in Arizona in April. Her participation was invaluable in adding to our workshop content on how articulation and educational mobility is occurring throughout the nation. This information was shared with workshop participants to provide them with a national perspective.

    e) Workshop participants evaluated the structure and outcomes of the workshops. Participant evaluations were uniformly positive about the content, structure and outcomes of the workshop.

    f) Workshop discussions were thoroughly transcribed, summarized and analyzed for major themes. These themes were organized into strategies by the leadership team.

    h) The workshop summary and suggested strategies were compiled into a draft report that was sent to all workshop participants for feedback. Comments were sent to the leadership team for revision of the document.

    i) A follow-up teleconference was held, for workshop participants to give additional input on the workshop report and recommendations. Twenty-five nurses participated, at six Kaiser teleconference sites throughout the state. The teleconference technology worked extremely well for this purpose, and will be used in the future to facilitate communication across the large distances in this state.

  3. The draft report and recommendations of the educational mobility workshops was widely distributed to CSPCN members and LVN, ADN and BSN directors. They were given the opportunity to discuss the recommendations and to make suggestions at their annual meetings. Written suggestions were incorporated into the draft document. The overall response of these groups was positive, with indications of continued enthusiastic support for achieving the objectives of this project.
  4. An executive summary and copy of the recommendations was included in Nursing Summit packets. (See description below.) The workshop report was finalized and distributed to workshop participants. A final copy will also be sent to all schools of nursing and members of CSPCN.
  5. The project leadership team participated in the planning for a statewide nursing summit on October 7, 1999, at the Sacramento Convention Center. Over nine hundred nurses participated in this summit! California has never experienced a non-union educational program of this magnitude in our entire history.
  6.  
  7. Two project staff, Diane Welch and Sherry Fox presented the work and the outcomes of this project at the summit.
  8.  
  9. Project staff leader, Diane Welch, attended the National Healing Web Conference in Quincy, Illinois, Oct. 14-16, 1999. The California articulation work from this project was presented to attendees (approximately 70). The presentation was well received. It was apparent from this conference that California is progressing rapidly in the area of educational mobility, and will be a model for others to follow.

Benefit to nursing students: Currently, 70% of the nursing workforce in California is educated at the associate level. California employers intend to hire greater numbers of nurses with bachelor and advanced degrees over the next 5 years. It became obvious throughout this project that California needs a streamlined articulation plan. To this end, the work of this project has far reaching applications and benefits to nursing students and practicing nurses in California. Approximately, 200 generic student nurses attended the 1999 Nursing Summit. The vast majority of these individuals are enrolled in ADN programs and found the recommendations from this project to be most encouraging.

Factors helping or impeding: There have were no major impediments to this project. The existing networking among service and education through CSPCN has been a true asset. The groundwork that has occurred previously through CSPCN and earlier articulation efforts in 1989-1991, has positioned us for much positive support and little resistance.

Future impediments may come from the political arena. California educators will need to expand existing programs and create new programs in an effort to meet the health care needs of Californians. The state legislature will need to expand or create new funding streams for nursing education. Governor Davis signed AB 655 in October 1999 which mandates the development of "a plan and budget for significantly increasing the number of students graduating from nursing programs in the state and for providing specialty training to licensed nurses in the prescribed areas of specialization." The plan is due to the legislature April 1, 2000. The Board of Registered Nursing has taken the lead on the project convening nurse leaders from across the state.

Unanticipated outcomes: None to date, though we were extremely pleased with the positive energy and cohesive efforts of the first regional workshop. It led us to believe that our extremely ambitious plans for this project can be realized in the near future.

Other observations: The process itself seems very timely—this state is ready for some concentrated attention on educational mobility and is ready to move forward. This observation was validated when over 900 nurses attended the 1999 Summit. This was an unprecedented event. At no time in our history have California nurses gathered in one location to discuss nursing. The process we have outlined seems very inclusive and we anticipate ultimate success.

Implementing the project: Based on our experience in implementing this project, some of our original expectations for achieving these outcomes were unrealistic given the time frame of the grant. Specifically, our goal to integrate differentiated practice competencies into an articulated nursing education model and identifying curricula for the AVN, ADN, BSN and MSN programs. While we made tremendous progress in these areas the process itself will take several years to fully integrate. The collaborative approach that was utilized proved to be extremely successful and has been carried over as we continue to move this agenda in 2000.

Future Activities: Activities are planned for the future as a result of this project. We reorganized the committees within the CSPCN to include a committee of educators and service individuals that will work on curricula and integrating differentiated practice competencies. The success of the 1999 Summit has provided a source of revenue to continue the work in part. In addition, CSPCN received a grant from the Robert Wood Johnson Foundation in July 1999 that will also ensure that the work continues. CSPCN Steering committee members continuously investigate opportunities for additional funding either through grants or partnerships.

Model Project: Diane Welch's experiences in at the National Healing Web Conference in Illinois indicate that California is progressing rapidly in this area of educational mobility. It is apparent that California with its 71 ADN programs and 18 BSN programs will be a model for others to follow. Our processes may also be emulated. Others can model strategies adopted for collaborating and disseminating the information. California is a diverse state and we have developed strategies that capitalize on our diversity but ensures that all sectors are represented.

Other states may wish to obtain a copy of our work that will be available through ACNL and on the CSPCN web page. Individual members of the leadership team are available for consultation from those states that are interested in our work. Members of the leadership team have already presented the information at national conferences and will continue to do so when appropriate over the ensuing years.

Outcomes:

Sincerely,

 

Patricia Lenihan McFarland, MSN, RN

Association of California Nurse Leaders