ESSENTIAL RESOURCES FOR ILLINOIS NURSE LEADERS WELCOME Thursday

ESSENTIAL RESOURCES FOR ILLINOIS NURSE LEADERS WELCOME Thursday, April 20 th 3: 00 pm-5: 00 pm Peoria Marriot Pere Marquette

Frank Bradtke, DNP, RN, NEA-BC IONL President Elect Director of Operations, ICU/TCU, Emergency Department, Telemetry & Stroke Program, Advocate Trinity Hospital

Today’s Agenda Topic Welcome & Introductions Presenter Time Frank Bradtke DNP-L, MSA, RN, NEA-BC 3 -3: 05 pm IONL President Elect Director of Operations, ICU/TCU, Emergency Department, Telemetry & Stroke Program, Advocate Trinity Hospital A Comparative Look at the Illinois Center for Nursing, Illinois Board of Nursing, and Illinois Healthcare Coalition Action Coalition and its Importance to a CNO Illinois Rules and Regulations Regarding Nursing Practice & Care Delivery Across the Continuum State Resources for Nurse Executives Basic Skills for Emergency Preparedness in the Healthcare Workplace Q&A Session IONL Overview & Closing Remarks Networking Melinda Noonan DNP, RN, NEA-BC, FACHE IONL Past President Assistant Professor, College of Nursing & College of Health Sciences, Health System's Management Rush University Program Director, Systems Leadership Doctor of Nursing Practice Program Deb Quintana MS, RN, APN, ONC, NEA-BC, CPHQ Director of Clinical Operations at Presence Resurrection Medical Center Melinda Noonan DNP, RN, NEA-BC, FACHE Barb Weintraub RN, MSN, MPH, APN Trauma/EMS/Pediatric Quality Coordinator - Gottlieb Hospital Melinda Noonan DNP, RN, NEA-BC, FACHE Frank Bradtke DNP-L, MSA, RN, NEA-BC IONL President Elect Director of Operations, ICU/TCU, Emergency Department, Telemetry & Stroke Program, Advocate Trinity Hospital 3: 05 -3: 20 pm 3: 20 -3: 40 pm 3: 40 -3: 55 pm 3: 55 -4: 10 -4: 20 pm 4: 20 -4: 30 pm 4: 30 -5 pm

BUSINESS ITEMS CE Process: Complete an evaluation following the conference and your CE certificate will be sent 2 weeks following the close of the evaluation. Networking from 4: 30 -5 pm Conference: Registration begins at 7: 30 am, Conference begins at 8: 30 am

Mission The organization for the advancement of leadership among Illinois nurses. Vision Organization of choice for nurse leaders throughout Illinois.

BENEFITS OF IONL MEMBERSHIP IONL unlocks the leader in you. Professional development opportunities, ranging from free lunchtime webinars to immersive fellowship training programs. IONL opens up career opportunities. Find your next position on IONL’s Career Center, exclusive to members. Earn Education Contact Hours through IONL’s educational programs. IONL connects you to fellow nursing leaders in Illinois. Through programs, events, committee and volunteer work, gain direct access to nursing peers and esteemed leaders in Illinois. IONL keeps your informed. IONL will keep you up to date on national and local health policy issues. IONL advocates for you. IONL is active in collaborative advocacy efforts with industry colleagues and partners. IONL saves you money Receive exclusive discounts on professional development education, employment listings on IONL’s Career Center, and insurance through Liberty Mutual.

Melinda Noonan DNP, RN, NEA-BC, FACHE IONL Past President Assistant Professor, College of Nursing & College of Health Sciences, Health System's Management Rush University Program Director, Systems Leadership Doctor of Nursing Practice Program

A Comparative Look at the Illinois Center for Nursing, Illinois Board of Nursing, and Illinois Healthcare Coalition Action Coalition and its Importance to a CNO Objective: Describe the purpose and functions of the ICN, IBON, and IHAC and resources to support nurse leaders

Illinois Board of Nursing • Nurses came under the jurisdiction of the Department upon its creation in 1917. • The regulatory Act includes "practical", "registered" and "advanced practice" nurses within its scope and includes nursing in all of its specialties. 11

Illinois Board of Nursing Duties include: • Making recommendations on the adoption of revisions to the rules and regulations necessary to carry out the provisions of the Act • Conducting hearings and disciplinary conferences upon charges calling for discipline of a licensee • Recommending approval or denial of nursing education programs 12

Illinois Board of Nursing • Thirteen members appointed by the Secretary, consisting of one nurse and one public member. • • • 4 advanced practice nurses (CNS, CNP, CNM, & CRNA) 3 nursing educator representatives (LPN, ADN, BSN) 3 registered nurses actively engaged in patient care 1 licensed practical nurse 1 nursing administrator 1 public member not employed in & no material interest in any health care field 13

Meetings • 6 x/year • Springfield • Chicago • Participate in disciplinary conferences with IDFPR attorney • http: //www. idfpr. com/pr ofs/Boards/nursing. asp

Responsibilities Recommend approval, denial of approval, withdrawal of approval, or discipline of nursing education programs • Feasibility study • Proposed curriculum

NCLEX Performance • Annual pass rate of first time examinees < 75%: written warning • . . . For two consecutive years: Probation • . . . For additional two years: Reevaluated for continued probation or possible disapproval • Schools with poor NCLEX performance are listed on the Center for Nursing website • NOTE: Approval =/= Accreditation *State of Illinois Rules for the Administration of The Nurse Practice Act Section 1300. 340 b)

Disciplinary Cases • Unethical or unprofessional nurse conduct • Fraud and deceit • Use of social media • Boundary violations • Sexual misconduct • Abuse • Positive criminal background checks • Practice Issues • Drug-related violations/substance use disorders

Outcomes to Disciplinary Conferences • Administrative warning letter – not public, not a discipline • Discipline • • • Reprimand Probation Suspension Revocation Fine

Recent IL BON Initiatives • proposed RN Program and PN Program Curriculum Checklists • METC Basic Medical Technical Corpsman Program to Practice Nurse Course Proposal • Strategies for Programs with < 75% NCLEX Pass Rates • Established work groups to develop recommendations for NPA Sunset

National Council of State Boards of Nursing (NCSBN) • 59 Member boards comprised of BONs in 50 states District of Columbia 3 States have 2 BONs (LPN and RN) – CA, LA, WV Nebraska has BON for Nursing, 1 for APRNs 4 US Territories -American Samoa, Guam, Northern Mariana Island, Virgin Islands • 16 Associate Members; most are in Canada • • • www. ncsbn. org

NCSBN Initiatives Regulatory Decision Pathway • Based on concept of Just Culture • Differentiate between behaviors that are • Human Error • At Risk • Reckless • Bad Intent • Disciplinary Action • Possible Law Enforcement Referral www. ncsbn. org

NCSBN Initiatives Nurse Licensure Compact (NLC) and APRN Compact • Adopted in 2000; Currently 24 states; Modeled after Driver’s License Compact • RN is licensed in primary state of residence and may practice physically or telephonically/electronically in other member states. • RN may practice in other member states unless there is a disciplinary action or restriction on the license. • RN living in non-compact state is not eligible for compact license; can be issued single-state license in a compact state. • RN is accountable for complying with the nursing practice laws and other regulations in the state where the patient is located at the time care is rendered. www. ncsbn. org/nlc

Illinois Center for Nursing

Illinois Center for Nursing (ICN) • The Board serves as an advisory body and has the following responsibilities: Develop a strategic plan for nursing manpower in Illinois Maintain a database on nursing supply and demand in Illinois Select priority issue areas within the nursing profession for the ICN to address Convene groups of stakeholders to recommend strategies and systemic changes within the nursing workforce • Enhance and promote recognition, reward, and renewal activities for nurses • Identify outside funding opportunities to achieve the objectives of the ICN • Assist in establishing programs to offer grants, scholarships and internships • • 24

2014 Nursing Workforce Study in IL • The cultural diversity of the RN workforce decreases in the younger cohorts • Voids in specialties such as psychiatric, school, home health and community health nursing • Significantly fewer RNs (ages 25 -35 years old) in the Ph. D education pipeline to replace the retiring RNs 25

Illinois Center for Nursing (ICN) • Mission • Advocate for and ensure appropriate nursing resources necessary to meet the health care needs of Illinois citizens • Through these efforts, ICN promotes access to health care, improved quality and decreased cost.

Background • Established through legislative action in 2006 and placed within the Illinois Department of Financial and Professional Regulation to address supply and demand in the nursing profession. • 11 members with diverse expertise appointed by the governor • Support of a managing director • Multiple coalitions with regional, state and national organizations to address statutory mandate.

Assessment • Accomplishments- Overall quality and capacity in RN programs increased by 57. 8% and in LPN programs by 18. 5% (2006 -2013) • Collaborated with Illinois Board of Higher Education for nursing program grants • 19 Nursing Schools Expansion and 23 Improvement grants awarded (2007 -2014) • 177 Nurse Educator Fellowships awarded with 88. 5% retention rate of educators in nominating schools of nursing (2007 -2013)

Assessment con’t • Collaborated with national and state groups • RWJF, AARP, ANA-Illinois, Illinois Nurses Foundation and IONL to form the Illinois Health. Care Action Coalition (IHAC)-RWJF state implementation program grant • Curriculum for progression between community colleges and higher degree programs, study of supply of APN’s and strengthening nurse leaders.

Assessment con’t Supported annually Clinical Faculty Academy programs • Prepare ~ 400 nurses with masters degrees with competencies to become nurse educators • Partnerships MCHC, Man-Tra-Con Corporation, IHA, ICAHN- 1 0 f 3 states chosen to be in the National Council State Board of Nursing Transition to Practice study • Collected data on nursing workforce

Survey Process • Survey was conducted during the 2014 IL RN license renewal period (3/6/14 to 5/31/14) • Over 90% of individual RNs complete license renewal via an online platform • 52, 902 responses, 31% response rate of the total RN population in Illinois (approximately 170, 000 RNs were licensed at time of survey) • The survey includes 28 questions consistent with the national minimum dataset requirements of the National Forum of State Nursing Workforce Centers http: //www. nursingworkforcecenters. org/minimumdatasets. aspx • The survey report is on the IL Center for Nursing (ICN) Website http: //nursing. illinois. gov/Research. Data. asp

Planning • RN’s represent the largest profession within the US health workforce with more than 2. 7 mil RN’s employed in 2010 (US Bureau of Labor Statistics 2012) • Forecasts demand for RN’s will result in 3. 5 mil nursing jobs by 2020 (26% increase over 10 years) • Demand is driven largely by population growth and increasing number of older Americans. • The ACA will likely impact upon the number of places where RN’s will work and the skills needed. • Most rapid growth is in OP, ambulatory and home health care environments

Issues • Projections of mass retirements of RNs and increased demands for advance practice nurses, nurse educators and those with new competencies • This requires understanding of national and state supply/demand.

Recommendations • Utilize current data to plan and project workforce needs • Build key strategic partnerships to facilitate the work of the ICN • Utilize existing state funds and seek additional non-state resources • Increase visibility and communicate the value of the ICN

Contact Information Illinois Center for Nursing James R. Thompson Center 100 W. Randolph Street Suite 9 - 300 Chicago , Illinois 60601 888 -NURSE 07 [888 -687 -7307] Email: FPR. ILCenterfor. Nurses@illinois. gov

The Future of Nursing in Illinois a Review of IOM Initiatives in Our State

RWJF/IOM Future of Nursing Advance education transformation. We need to prepare our nursing workforce for the future by strengthening education and training. Remove barriers to practice and care. We need to expand access to care by maximizing the use of nurses and modernizing outdated policies that prevent nurses from practicing to the full level of their education and training. Leverage nursing leadership. We need to prepare the next generation of nurses to meet the health care needs of people, their families, and the communities where they live and to position nurses to lead system change. Promote diversity. We need to recruit and prepare the nursing profession to provide culturally competent care in a variety of settings to an aging and more ethnically diverse population with more chronic illnesses. Foster interprofessional collaboration. We need to promote a team-based approach to education and practice to improve the quality and coordination of health care. 37

Campaign Vision Everyone in America can live a healthier life, supported by a system in which nurses are essential partners in providing care and promoting health.

Areas of Focus Education Practice & Care Diversity Leadership Interprofessional Collaboration

Illinois Healthcare Action Coalition (I-HAC) • Supported by RWJF SIP Grant 2014 -2015 ($150, 000) • Co-Leadership • Illinois Organization of Nurse Leaders • ANA-Illinois • Illinois Center for Nursing 40

41

42

Leadership Workgroup Deliverables • IONL Study- # of members who are certified and serving on boards • Toolkit to Advance Nursing Education • Talking Points- The Importance of Joining a Professional Nurses Association • Leadership Competencies- for all levels of nursing • Leadership Certification- a grid summarizing the leadership certifications available to nurses • Conducted a Survey on Networking for Nurse Leaders • Conduct a Statewide Survey of Nurses on Certification • Created a Resource List for Nurses Interested in Preparing for a Governing Board Appointment • Board Training Webinar on 6/24/15 & 7/15/15

IHAC’s Website http: //www. illinoishac. com/

IHAC is on Facebook

Your Role in this Initiative • Understand • Communicate • Educate • Participate • Visit websites

Going Forward http: //campaignforaction. org/state/illinois • Subscribe: Sign up to receive Campaign for Action updates through email • Register Now • Join the conversation: Go to the Online Community

Questions?

Deb Quintana MS, RN, APN, ONC, NEABC, CPHQ Director of Clinical Operations at Presence Resurrection Medical Center

Key Illinois Laws Impacting Nursing Practice

Focus on Spending

External Interests & Pressures Agency ital p s o H S CM e Compar US News & World Report Facility Specific for Healthcare Research & Quality Tribune National orum Quality F Commercial Payers Consumer Reports Health Grades IL Hospital Report Card Why Not t he Best? Commonw ealth Fund 53

Legislative & Regulatory Environment

Over a Decade………

Hospital Report Card Act (2004) • First law of its kind (PA 93 -0563) § Provides public a picture of each hospital’s staffing process as it relates to patient outcomes § Profiles RN/LPN/assistive nursing personnel by clinical service area & vacancy/turnover § Mandates sharing current unit schedules, nurse-pt assignments and methodologies for staffing levels upon request http: //www. healthcarereportcard. illinois. gov/

Hospital Report Card Act Consumer Guide to Health Care & Hospital Report Card Act (www. healthcarereportcard. illinois. gov) § Volume & cost of services in hospitals & ASTCs § Nurse Staffing § Quality üprocess of care, readmission rates, 30 day mortality, inpatient mortality, inpatient utilization § Safety üsurgical care improvement, CLABSI/CDI/MRSA, patient safety (e-codes)

Mandatory Overtime Prohibited (2005) 11 th State Only in the event of an emergent circumstance may nurses be required to work overtime and then only for four hours beyond a nurse’s predetermined, agreed work shift. Nurses may choose to work extra hours. (PA 94 -0242)

Nurse Staffing by Patient Acuity (2007) Staffing in the acute care setting should be based on the complexity of patient care needs all aligned with available nursing skills to promote quality patient care that is consistent with professional nursing standards

Staffing by Acuity (2007) Committee requirements üAn existing or newly created hospital-wide committee or committees. üContribute to development, recommendation & review of the hospital’s staffing plan. üHospital shall appoint members of a committee, w/at least 50% are RNs providing direct patient care. üRN members must be broadly representative of clinical service areas, as reasonable, e. g. , surgery, critical care, pediatrics. üWhen not practical to include representative from each clinical service area at one time – may schedule for rotating representation, for a defined period of time, to achieve input from all clinical service areas, every three years.

Respiratory Therapy HB 408 – Rep. Zalewski § Update to 10 year old Practice Act § Patient safety issues - connect & disconnect activities § Revised what is NOT basic respiratory activities üTransfer of devices for anyone less than 12 years and any adult w/6 L oxygen or more – only licensed hands

Opioids HB #1 (Rep. Lou Lang) § Comprehensive initiative § Prevent heroin use & abuse of prescriptive substances § Source reduction & proper waste management § Increase awareness, education & access to opioid antagonists üSchools, law enforcement, EMS, public

Opioids • Report to the Illinois Department of Public Health (IDPH) within 48 hours of providing treatment for a drug overdose in the emergency department or when a drug overdose is confirmed. • Report needs to include whether an opioid antagonist was administered, the cause of the overdose and the demographic information of the person treated and identifiable information of the person experiencing the overdose will not be disclosed. • Have physicians and other authorized prescribers document in the patient’s medical record the medical necessity for the amount and duration of any three sequential 30 - day prescriptions for Schedule II narcotics. • IDPH has not created actual “rules” yet

Senate Bill 2403 “Gabby’s Law” • Requires hospitals to have early identification protocols for sepsis • Specific components of the protocols target children • Requirement for developing education regarding sepsis, and it is ongoing

Human Trafficking Public Act 99 -0099 “If you or someone you know is being forced to engage in any activity and cannot leave, whether it is commercial sex, housework, farm work, construction, factory, retail or restaurant work, or any other activity, call the National Human Trafficking Resource Center at 1 -888 -373 -7888 to access help and services. Victims of slavery and human trafficking are protected under United States and Illinois law. The hotline is: * Available 24 hours a day, 7 days a week. * Toll-free. * Operated by nonprofit nongovernmental organizations. * Anonymous and confidential. * Accessible in more than 160 languages. * Able to provide help, referral to services, training, and general information. ”

Caregiver Advise, Record and Enable Act (CARE Act) Public Act 99 -0222 1. Offer hospital inpatients the opportunity to designate a family member or friend as a caregiver to provide aftercare in the patient’s residence after discharge; record the caregiver’s name, if one is designated. 2. Notify the caregiver of the patient’s upcoming discharge or transfer. 3. Consult with and provide a discharge plan to the caregiver that includes the aftercare that the patient will require. 4. Make an effort to provide instruction to the caregiver in the after care tasks described in the discharge plan.

Healthcare Surrogate Act Order of Priority v the patient's guardian of the person v the patient's spouse v any adult son or daughter of the patient v either parent of the patient v any adult brother or sister of the patient v any adult grandchild of the patient v a close friend of the patient v the patient's guardian of the estate

State Resources for Nurse Executives Melinda Noonan, DNP, RN, NEA-BC, FACHE Program Director, Systems Leadership Doctor of Nursing Practice Program Rush University

Resource Review • Illinois Board of Nursing http: //www. idfpr. com/profs/Boards/nursing. asp • Illinois Nurse Practice Act www. ilga. gov/legislation/ilcs 5. asp? Act. ID • Illinois Center for Nursing FPR. ILCenterfor. Nurses@illinois. gov • Illinois Healthcare Action Coalition http: //www. illinoishac. com/ • Illinois Health Report Card http: //www. healthcarereportcard. illinois. gov/

Resource Review • National Incident Command Management http: //www. fema. gov/national-incident-managementsystem/training • Illinois Organization of Nurse Leaders www. ionl. org

Illinois Department of Financial & Professional Regulation • e. License Search • License Lookup • License Renewal • File a Complaint • Enforcement Actions www. idfpr. com

As of Jan. 1, the Metropolitan Chicago Healthcare Council and the Illinois Hospital Association completed a combination agreement and officially have become the Illinois Health and Hospital Association (IHA). Our integrated organization has a new website URL “www. team-iha. org” and a new email address “@teamiha. org”. New Email Domain: @team-iha. org

IHA Websites Metropolitan Chicago Healthcare Council (MCHC) - www. mchc. com COMPdata Informatics - www. compdatainfo. com IHA Insurance Solutions - www. ihainsurancesolutions. com Illinois Association of Healthcare Attorneys - www. iahanet. org Illinois Health Care Jobs - www. ilhospitaljobs. com Illinois Poison Center - http: //illinoispoisoncenter. org/ IPC Group Purchasing - www. ipcgrouppurchasing. com Medical Alliance Insurance Company - http: //maicinsurance. com Midwest Alliance for Patient Safety www. alliance 4 ptsafety. org National Hospital and Healthcare Careers - www. hospitalcareers. com Transforming Illinois Health Care www. transformingillinoishealthcare. org

If you are looking for the Illinois Chapter of American Nurses Association Choose this… Not this… ILLINOIS NURSES ASSOCIATION The Nurses' Union

Illinois Society for Advanced Practice Nursing P. O. Box 636 Manteno, IL 60950 ISAPN provides continuing education Phone: 815 -468 -8804 programs, offers opportunities to collaborate with other professionals and organizations and supports legislation as it relates to Advanced Practice Nurses. Through an annual conference and periodic seminars related to issues facing APN's today, ISAPN offers opportunities for continuing education and networking. ISAPN is involved in a variety of activities that promote and advocate for Illinois Advanced Practice Nurses. ISAPN actively examines the actions of the legislative and administrative branches of Illinois government. ISAPN advocates for and represents the positions of the APN's of the state of Illinois.

Barb Weintraub RN, MSN, MPH, APN Trauma/EMS/Pediatric Quality Coordinator - Gottlieb Hospital IONL Nurse Planner

Emergency Preparedness for Nurse Leaders

“There was a red button on the wall labeled EMERGENCY, but no button labeled BEWILDERMENT. ” ~Michel Faber, The Book of Strange New Things

Four stages of preparedness �Mitigation ◦ Eliminate/mitigate known issues �Preparedness ◦ Prepare yourself and the entire hospital �Response ◦ Action time �Recovery ◦ Return to baseline

Learn �Prepare by educating yourself �National Incident Management System (NIMS) ◦ ◦ NIMS 100 NIMS 200 NIMS 700 NIMS 800 www. fema. gov/national-incident-management-system/training

Learn �IDPHnet. illinois. gov ◦ This is the IDPH HAN alert website to record bypass, resources needed, alert, etc. ◦ Know how to use or delegate someone to update the IDPH website on your current status and notify your EMS regional site. � State of Illinois Emergency Operations plan ◦ https: //www. illinois. gov/iema/Preparedness/Documents/IEOP. pdf

Practice �Understand All Hazards approach �Drill entire hospital, not just E. D. �Practice Incident Command for small events, so process is familiar when “the big one hits” �Ensure that everyone knows who, what, when and where Incident Command will be when an incident occurs. �Have all potential participants in Incident Command rotate roles, as roles may change dependent upon day/time/shift of incident

�Make sure every department knows their individual unit’s responsibility in the hospital plan �Every unit participates �Not business as usual �Review, revise, “hot wash” �Participate in drills with Fire, Police, EMS, and County Emergency Preparedness. This will help to identify the gaps you will encounter

Response �Once the incident occurs…

“Fear is the mind-killer. ” ~Frank Herbert, Dune

�Put on the vest and start activating the Emergency Operations Plan.

�Set up the Command Structure immediately, and flesh out I. C. structure as additional personnel arrive �Use your resources, use technology, if possible have a room or response cart set up just for Incident Command.

Biggest pitfall in emergencies �Failure to Communicate ◦ External – Local, County, Use your PIO ◦ Internal – use the structure and hold every 20 -30 minutes briefings to the Incident Command Staff ◦ Don’t forget the “boots on the ground” staff

My real life experiences

Take Home Messages �Stay calm, many eyes are on you. �Try your best to implement the plan. �Protect patients, staff, and others from the emergency. �Call for help, supplies, or mutual aid. �Don’t be afraid to ask for help! This is not business as usual

Final words of Advice…. �Know you will make mistakes, learn from them, and teach others. �Practice, Practice. . . each emergency is different so you never really get “good” at this stuff.

Q&A with Melinda Noonan

Thank you for attending today’s Essential Resources for Illinois Nurse Leaders *Don’t forget to complete the evaluation sent via email following the conference.