5. Recommendations

1. Prioritize funding for initiatives to increase the proportion of BSNs in the nursing workforce.  Fund programs, demonstration projects, evaluations, and/or research efforts that:

• Prepare nursing faculty to meet the increased demand for BSN-level and higher degree graduates through expansion of PhD programs and provide incentives to encourage practicing nurses to become clinical faculty.  Increase the number of MS-to-PhD programs in nursing.
• Give funding preference to pre-baccalaureate (associate degree/diploma) education programs that demonstrate a plan to foster baccalaureate preparation with partnerships between baccalaureate and pre-baccalaureate programs.
• Employ and integrate technology (e.g., distance learning and simulation) into the educational process and curriculum content.
• Facilitate partnerships between health care systems and nursing programs to matriculate existing nursing personnel into baccalaureate degree programs.

2. Prepare RNs for future challenges by increasing support for efforts to improve nursing education.  Fund programs, demonstration projects, evaluations, and/or research efforts that:

• Create shared regional clinical simulation centers, technology centers, and virtual skills labs to complement clinical rotation and provide access to evidence-based practices.
• Prepare students and faculty to deal with surge demands (e.g., sudden increases in the need for nursing services), in order to more effectively address health crises such as natural or man-made disasters.
• Continue to examine the relationships between the level of nursing education of Registered Nurses in various practice settings and patient outcomes.
• Support partnerships between hospitals and academic nursing institutions to assist hospitals in achieving evidence-based status.
• Identify and disseminate evidence-based practice curriculum models.

3. Increase the diversity of nursing students and the cultural competence and sensitivity of RNs.  Fund programs, demonstration projects, evaluations, and/or research efforts that:

• Prioritize funding for colleges and schools of nursing that identify and implement plans for recruiting, retaining, and graduating more diverse students, and for recruiting and retaining more diverse faculty.
• Apply evidence-based curricular models that prepare existing and future nurses to provide culturally competent care.
• Evaluate and disseminate best-practice models that increase nursing school graduation rates for those groups with lower completion rates.

4. Support initiatives to optimize the nursing work environment. Fund programs, demonstration projects, evaluations, and/or research efforts that:

• Support nursing outcomes research to identify effective nursing practices such as studies of patient-centered care delivery models, the impact of different nurse-to-patient ratios, and the use of nursing-sensitive performance measurement.
• Evaluate and improve the nursing work environment and workflow processes to enhance nurse retention, safety, satisfaction, productivity, and patient outcomes (e.g., via “Enhancing Patient Care” grants that address the aging workforce, decrease job burnout, reduce latent errors, lessen burdensome paperwork, and facilitate technological solutions).
• Improve non-mortality incident (e.g., falls, pressure ulcers) outcome measures and associated data collection in Federally mandated datasets (e.g., Center for Medicare and Medicaid Services data reporting requirements).
• Implement evidence-based RN retention models across the health care system. 

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