New York’s ‘BSN in 10’ Law And The Push For 80% Of Nurses To Hold BSN By 2020 | Nurse.org

Update: 12/30/2017 at 9:12pm PST After nearly 14 years of lobbying, New York State finally passed their “BSN in 10” law. The state now requires all nurses to obtain a Baccalaureate Degree in Nursing within 10 years of receiving their initial RN license. New York state may be the first state to actually pass the law but, many other states have plans to enact similar legislation in the near future.  What Does ‘BSN in 10’ Mean To NY Nurses & Students? According to the bill, if a Registered Nurse does not re

Source: New York’s ‘BSN in 10’ Law And The Push For 80% Of Nurses To Hold BSN By 2020 | Nurse.org

 

Update: 12/30/2017 at 9:12pm PST

After nearly 14 years of lobbying, New York State finally passed their “BSN in 10” law. The state now requires all nurses to obtain a Baccalaureate Degree in Nursing within 10 years of receiving their initial RN license.

New York state may be the first state to actually pass the law but, many other states have plans to enact similar legislation in the near future.

What Does ‘BSN in 10’ Mean To NY Nurses & Students?

According to the bill, if a Registered Nurse does not receive a Baccalaureate Degree within 10 years, their license will be suspended.

How does this law effect nurses who hold a New York nursing license but do not have plans to complete a bachelor degree? At this time, registered nurses who hold a New York license will be grandfathered in – regardless of degree level.

Current nursing students enrolled in nursing programs within New York are also exempt from the bill.

However, going forward, all RNs entering the profession are now required to pursue a BSN within 10 years of receiving their RN license.

Institute of Medicine Recommends 80% Of Nursing Workforce To Have BSN Degree By 2020.

Nurses are the eyes, ears, and heart of healthcare, but the profession is undergoing some major changes; one of the reasons for such change is due to increasing educational expectations.

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The Institute of Medicine reported on the future of nursing in 2010, making a strong recommendation that 80 percent of the nursing workforce have a baccalaureate degree (BSN) by 2020. At the time of the report’s release,  only 50 percent of the nursing workforce had a BSN. Now, there is an estimated 55-60 percent of nurses who have such a degree. “Research has shown a higher percentage of baccalaureate nurses on a unit reduces morbidity and mortality,” says Tina Gerardi, the Deputy for the Academic Progression in Nursing Programs (APIN).

APIN is a grant initiative of the Robert Wood Johnson Foundation focused on identifying the best progression models for successfully urging more nurses to earn a bachelors degree.

Nursing Changes

One change on the horizon for the nursing profession is the pending retirement of a massive number of nurses who are members of the Baby Boom generation. Additionally, the Affordable Care Act (ACA) has done its part in expanding the need for nurses who can provide care for an increasing number of insured Americans.

“The thing is, we are going to need all the nurses we can get,” says Peter McMenamin, senior policy fellow at the American Nurses Association; “the BSN percentage of new grads is increasing slowly.”

Once all the Baby Boomer nurses do indeed retire, that will in and of itself alter the statistics in terms of the percentage of nurses with a BSN; since approximately 75 percent of Baby Boomer nurses do not have their BSN, their collective retirement will alter the calculus of the situation.

“The field is becoming more complicated,” said McMenamin. “Some people have reservations that the associate degree nurse isn’t any less qualified than a BSN. They say that the associate degree nurse is getting the clinical and technical training that the BSN nurses get, but it’s crammed into a shorter amount of time at a different level.”

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The NCLEX (National Council Licensure Examination)

Today, all aspiring nurses must pass the NCLEX, which is administered by the National Council of State Boards of Nursing (NCSBN). The NCLEX is a standardized exam that each state board of nursing uses to determine whether or not a candidate is prepared for entry-level nursing practice.

Before you can take the NCLEX, the first step is to successfully complete an accredited nursing degree. Hundreds of nursing schools have customized their ADN to BSN programs in order to help those who want to earn that degree.

Related: Tips To Surviving The NCLEX

MONEY AND TIME

Earning a bachelor’s degree in nursing takes longer (at least a year or two) than an associate degree, and the cost is more significant, as well.

Scholarships can be difficult to come by when returning to school, and many older nurses have families to care for and other responsibilities. These nurses are often earning a decent income with their associate degree, and unless more money is available for scholarships to inspire nurses to go back to school – which happened in 1971 with an Act of Congress because of a huge nursing shortage – most established ADNs will stay where they are and not pursue further education that may or may not increase their earning power.

According to the Bureau of Labor Statistics’ Employment Projections for 2014-2024, the career of an RN is listed among the top occupations in terms of job growth. The RN workforce is expected to grow from 2.71 million in 2014 to 3.24 million in 2024, an increase of 439,000 or 16%.

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What’s The Plan To Increase The Percentage Of BSN Nurses?

In some areas and in some hospitals, the 80 percent will be achievable in less time, but every situation is unique.

For now, APIN has discovered that the top progression model for nursing is the shared curriculum model – students working simultaneously at community colleges and universities to earn their BSN. New Mexico State University developed the model, and many community colleges have linked with universities in this regard.

“This model works well because some medical centers and hospitals were closing off their clinical to associate degree candidates and only taking bachelor program students,” said Gerardi.

Part of the labor for initiating this model is successfully encouraging community colleges and universities to work with students to maximize financial aid and affordability.

Another area that begs for change is assisting associate degree nurses with health insurance if they go part-time at work in order to complete their BSN.

“There needs to be some flexibility and creativity to continue to provide those benefits when an employee is working on a reduced schedule,” says Gerardi. “Some employers have gone as far as to open up areas on their campus where students do their coursework on breaks or bring in faculty to do on-campus courses.”

Next Up: 2018 Online RN To BSN Degrees In Every State.

Lee Nelson of the Chicago area writes for national and regional magazines, websites, and business journals. Her work has recently appeared in Realtor.org, Nurse.org, Yahoo! Homes, ChicagoStyle Weddings, and a bi-weekly blog in Unigo.com.

How the Future of Work May Impact Our Wellbeing – RWJF

Work is a powerful determinant of health. As these stories about taxi, care, and cleaning work from a new report show, it is a central organizing feature of our lives, our families, our neighborhoods, and our cities. And work—its schedules, demands, benefits, and pay—all formally and informally shape our opportunities to be healthy.

Source: How the Future of Work May Impact Our Wellbeing – RWJF

The Electronic Health Record Problem | Commonwealth Fund

EHRs have one critical performance requirement: generating clinical revenues. In the fee-for-service world

Source: The Electronic Health Record Problem | Commonwealth Fund


It’s no secret that many physicians are unhappy with their electronic health records (EHRs). They say they spend too much time keying in data and too little making eye contact with patients. They say their electronic records are clunky, poorly designed, hard to navigate, and cluttered with useless detail that colleagues have cut and pasted to meet documentation requirements. Meanwhile, the data they really need are buried almost beyond retrieval.

Not all physicians feel this way. Two-thirds of primary care physicians say there are satisfied with their current EHRs, according to a 2018 survey by The Harris Poll. But the critics have a point. Current EHRs are not well-designed to meet the needs of users. And they don’t do enough to make clinicians smarter and more efficient. This doesn’t mean we would be better off in the paper world of 10 years ago. But it does mean that EHRs need improvement.

As we think about improving them, we need to broaden the discussion of EHRs and their role. We need to reckon with the underlying causes of EHRs’ problems, how to correct them, and how to ensure that their enormous potential benefits are understood and realized.

The Causes

EHRs are a technology. Like most technologies, they can be used in a variety of ways for a variety of purposes. Their human masters decide.

In our current health system, EHRs have one critical performance requirement: generating clinical revenues. In the fee-for-service world, this means supporting providers’ billing and documentation to generate as much revenue as possible for each clinical service. EHRs also must help providers meet regulatory requirements that may have financial or accreditation implications.

This means that current EHRs were not created to support many of the things that physicians, patients, and policymakers value: better care experiences, reduced costs, or improved care quality and population health management. They were not created to make physicians better diagnosticians or more cost-effective prescribers. The reason: our health care system has mostly not rewarded these activities. They have not been mission-critical for providers or, therefore, EHR designers.

For that reason, EHRs have only the most minimal capabilities related to clinical decision support, which has been proven to increase the quality of care, or to the collection of information on duplicate and unnecessary testing, or on the aggregate health of providers’ patient populations.

To put it simply, improving EHRs will require changing the priorities governing their design. That means moving away from fee-for-service payment toward risk-sharing by providers and, ultimately, some form of prospective compensation. Until then, optimizing the usability and value of EHRs will be an uphill struggle.

EHRs’ Undervalued Benefits: Empowering Patients and Advancing Human Health

Because the benefits of EHRs may be less visible than their burdens, some of their contributions are overlooked and undervalued.

One of these benefits is giving patients access to their medical information. Meaningful-use requirements spurred the adoption of patient portals, which, though sometimes clunky, have enabled patients for the first time to routinely see their test and procedure results. Patients can also now download their entire digital record and share it with third parties that can analyze its contents and educate them on their significance. Apple, for example, has agreements with over 100 health systems and practices to perform this function, which is likely to spawn a deluge of consumer-friendly health care applications based on patients’ own information.

Another underrated EHR benefit is that, by capturing billions of patient encounters worldwide, electronic records are generating a vast store of digital health data that are available for novel uses, including research into the causes and cures of disease and the detection and prevention of threats to public health.

Think of these data as the equivalent of a new natural resource, like water or minerals; they sit in the cloud, ready for extraction, refinement, and application. Their value is increasingly understood by technology companies, new startups as well as old stalwarts, that are pouring billions into exploiting them. There are obvious privacy and security issues raised by this development. But never before in human history have we had access to this novel (un)natural resource.

In entering all that data at the point of clinical care, health professionals and patients are creating a public good. But they get little tangible in return — at least in the short run. This maldistribution of benefit and cost lies at the heart of the current EHR controversy.

What Next?

To make health professionals’ work easier, and to exploit the vast potential of EHRs, a number of interventions make sense.

The most important is unrelated to the technology. Clinicians unhappy with EHRs have a huge stake in moving from fee-for-service to value-based payment, so that providers and their EHR vendors start to prioritize the production of health and the reduction of waste in health systems. This will reduce documentation requirements, spur the creation of decision support and information exchange that make clinicians’ lives better, and focus attention on getting value from the information so laboriously recorded by doctors and other health professionals.

A second requirement will be to lower the burden of data entry. Many providers have started using scribes to take notes during visits. While many physicians love scribes, they are expensive. A better long-term solution would be to use natural language processing and artificial intelligence to enable clinicians’ conversations with patients and their subsequent assessment and treatment plan to be recorded in real time. Given the increasing power of these technologies, such applications will soon be available.

Another approach to assisting data entry is to systematically redesign records for ease of use and to prune away unnecessary recording requirements. A recent New England Journal of Medicine commentary provided an excellent example of the benefits of this intervention.

A third requirement for EHR improvement falls to health professionals. When I was a medical student, I spent hundreds of hours learning how to take notes in the paper world. More experienced clinicians reviewed and graded these write-ups. Later, as a young physician, I observed the notes of clinicians I admired, and emulated them. This process of professional education in record-keeping unfolded over years and forever shaped my note-writing habits. If physicians are unhappy with how their colleagues use EHRs, they should start educating young physicians — and their peers — on how to properly keep records in the electronic world. What and how data get recorded are ultimately a professional responsibility.

Lastly, we need to find a way to correct the maldistribution of costs and benefits that now plagues the use of EHRs. By creating vast troves of electronic data and enabling patient empowerment, clinicians and their patients perform a valuable public service that has thus far been unrecognized and unrewarded. Reducing the cost of data entry will help, but as the benefits of EHRs and their data become monetized — as they will — some way to share those gains with clinicians and patients at the frontlines should be considered. This could be accomplished in a variety of ways such as voluntary contributions from businesses that rely on EHR data to an EHR innovation fund and/or directing a share of the taxes paid by these businesses to EHR improvement. But at least until EHRs become much more user friendly, this problem of unfair allocation of benefit and cost needs attention.

We are not going back to the paper world, but EHRs need to work better. As they pursue this goal, clinicians, policymakers, managers, and vendors need to understand and address the root causes of the problem they are trying to solve, and the full array of options for addressing it.

 

Project SEARCH and HealthMatters Program 2019 Webinar Series: Employment, Health, and Wellness

Please mark your calendars for the upcoming webinars. Webinars will be recorded and archived. These webinars are open to anyone with an interest in employment, transition, health, and wellness for people with developmental disabilities. 

These webinars are hosted by the HealthMatters ProgramTM in partnership with Project SEARCH® and funded by The Rehabilitation Research and Training Center on Developmental Disabilities and Health (RRTCDD). The RRTCDD is funded through United States Department of Health and Human Services, Administration for Community Living (ACL), National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR), Grant # 90RT5020-01-00 and the Ohio Developmental Disabilities Council, Grant # 17CH03FA19.

Please visit Project SEARCH and HealthMatters YouTube Playlist for the 2017-2018 Project SEARCH and HealthMatters Program Employment, Health, and Wellness Webinar Series.

Tentative Webinars and Schedule for 2019


PLEASE NOTE

  • There is no cost for these webinars.
  • CEUs are not offered for these webinars.
  • For disability accommodations email Jasmina Sisirak (jsisirak@uic.edu) at least 10 days before the webinars.

The webinars are hosted by the HealthMatters ProgramTM in partnership with Project SEARCH® and funded by The Rehabilitation Research and Training Center on Developmental Disabilities and Health (RRTCDD). The RRTCDD is funded through United States Department of Health and Human Services, Administration for Community Living (ACL), National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR), Grant # 90RT5020-01-00 and the Ohio Developmental Disabilities Council, Grant # 17CH03FA19.

Opportunity Insights

Source: Opportunity Insights

The Opportunity Atlas: Mapping the Childhood Roots of Social Mobility

The Opportunity Atlas

Which neighborhoods in America offer children the best chance to rise out of poverty?

The Opportunity Atlas answers this question using anonymous data following 20 million Americans from childhood to their mid-30s.

Now you can trace the roots of today’s affluence and poverty back to the neighborhoods where people grew up.

See where and for whom opportunity has been missing, and develop local solutions to help more children rise out of poverty.

Office of Disability Employment Policy Publications

Source: Office of Disability Employment Policy Publications | Pueblo.gpo.gov

Disability Employment Publications

Order FREE disability employment guides for employers, job-seekers, educators, and employment service providers.

Employers can find information to help recruit, hire, and retain employees with disabilities. Job-seekers with disabilities can find information to develop their skills and find the support they need to get a job.

You may preview products by clicking on each product’s name. Adobe Acrobat Reader is required to view the products and is available for download at: http://get.adobe.com/reader

“America’s Workforce: Empowering All” 

Source: NDEAM 2018 | “America’s Workforce: Empowering All” | Office of Special Education and Rehabilitative Services Blog

Note: October is National Disability Employment Awareness Month

National Disability Employment Awareness Month (NDEAM), observed each October, celebrates the contributions of workers with disabilities and promotes the value of a workforce inclusive of their skills and talents. Reflecting a commitment to a robust and competitive American labor force, this year’s NDEAM theme is “America’s Workforce: Empowering All.”

To recognize NDEAM, the Office of Special Education and Rehabilitative Services (OSERS) will publish a series of blogs, in partnership with the Council of State Administrators of Vocational Rehabilitation, throughout the month. The series will celebrate the career successes of individuals with disabilities who received vocational rehabilitation (VR) services and highlight some of the partnerships state VR agencies have established with businesses across the country.

For more information about NDEAM, visit our partners at the U.S. Department of Labor’s Office of Disability Employment Policy.

Health Care Coverage and Access in Your State

 

Health care is top of mind for a lot of voters going into this November’s mid-term elections, with many  concerned about the costs of care and about funding for Medicare and Medicaid. To provide an overview of health care coverage and access around the U.S. in the years since the Affordable Care Act expanded health coverage, we’ve created facts sheets for each state and the District of Columbia. The fact sheets show changes over time in: the percentage of uninsured adults and adults going without care because of costs, enrollment in marketplace plans and Medicaid, and the amount of federal support for health coverage.

Visit Health Care Coverage and Access in Your State to get the facts on health care coverage and access in your state.

Main conclusions agreed during the Summit on Intellectual Disability and Dementia

PRINCIPALES CONCLUSIONES ACORDADAS DURANTE LA CUMBRE SOBRE DISCAPACIDAD INTELECTUAL YDEMENCIA

ISSN: 0210-1696

DOI: http:/ /dx.doi.org/10.14201/scero2018492115122

Matthew P. JANICKI University of Illinois at Chicago, USA

Karen WATCHMAN University of Stirling, Scotland, UK

Juan FORTEA ORMAECHEA Centro Medico de Down de la Fundaci Catalana de Sindrome de Down (FCSD) y Servicio de Neurologia def Hospital de la Santa Creu i Sant Pau jfortea@santpau.cat

Y miembros de! International Summit on Intellectual Disability and Dementia

Health indicators in intellectual developmental disorders: The key findings of the POMONA‐ESP project

Source: Health indicators in intellectual developmental disorders: The key findings of the POMONA‐ESP project – Folch – – Journal of Applied Research in Intellectual Disabilities – Wiley Online Library

Annabel Folch, Luis Salvador‐Carulla, Paloma Vicens, Maria José Cortés, Marcia Irazábal, Silvia Muñoz, Lluís Rovira, Carmen Orejuela, Juan A. González, Rafael Martínez‐Leal

Abstract

Background

The aim of this paper was to summarize the main results of the POMONA‐ESP project, the first study to explore health status in a large representative, randomized and stratified sample of people with intellectual developmental disorders in Spain.

Methods

The POMONA‐ESP project collected information about the health of 953 individuals with intellectual developmental disorders.

Results

Diseases such as urinary incontinence, oral problems, epilepsy, constipation or obesity were highly prevalent among the participants; with gender‐differentiated prevalences for certain conditions, and age and intellectual disability level as risk factors for disease. Overmedication was common in the sample, and drugs were often prescribed without any clinical indication or follow‐up. The present authors also found a lack of important relevant information about the participant’s health and a lack of adequate genetic counselling.

Conclusions

Our findings may contribute to a better understanding of health status and needs of people with intellectual developmental disorders and suggest several courses of action to improve their health care.

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