Arizona nursing connections: Conclusion of AzNA's Practice Grant

Arizona Nurse, Jul 2001

With the ending of two major nursing projects in Arizona, the Arizona Nurses Association's (AzNA's) Practice Grant has also concluded. AzNA was awarded $16,000 by ANA in 1997 to monitor the progress of several exciting nursing projects underway in Arizona, identify emerging themes, communicate this information to the nursing community, and make recommendations to the AzNA Board of Directors regarding scope of practice or legal regulatory issues that might emerge from the analysis. This report summarizes the activities of the Practice Grant as well as provides information about the nursing projects.

An advisory committee identified five promising projects underway in Arizona. These were selected as exemplars of work that could positively affect the future of nursing and deserved to be highlighted for the nursing community. The projects were Colleagues in Caring, The Healing Community, Healthy Seniors-Community Nursing Organization project, the Maricopa Educational Project (HOES), and Nursing Report Card project.

The findings and recommendations of the Advisory Committee were facilitated through a process called "Concept Mapping." The concept mapping process is a type of structured conceptualization carried out in five steps:

Stepl. Preparation: the committee developed the focus by discussing the projects and extracting common themes.

Step 2. Generation of statements: staff extracted statements from meetinD discussions, interviews and notes, which were then reviewed by the committee.

Step 3. Structuring of statements: committee members individually sorted and rated the statements; responses were entered into a computer.

Step 4. Representation of statements: a computer program developed concept maps of clusters of themes.

Step 5. Interpretation of maps: the committee used the cluster maps to develop recommendations for the association.

Fifty-six statements were extracted from the minutes, tapes of meetings and notes. After each committee memnber ranked and sorted the item statements, their responses were fed into a computer. The computer program generated eight clusters of statements. The committee named the computer-generated clusters as follows:

1. Integration and collaboration

2. Communication

3. Projects

4. Outcomes

5. Quality of care

6. Future projects, subject not addressed by any project

7. Unlicensed assistive personnel

8. AzNA-ANA issues

Bridging or combining clusters into a "region" was allowed with this program. The committee felt that clusters 2, 3, and 4 could be bridged.

Some discussion focused on Cluster 6, with comments that the CNA issues of preparation, turnover and shortage were a concern but it appeared that no group was addressing this. Similarly, discussion about Cluster 7, unlicensed assistive personnel (UAP), centered on the education, competencies, and lack of standardization of the UAP, the challenge to nurses overseeing their duties and what state governmental agency should oversee these concerns. Another observation noted by the group was that there was not as much focus of projects as the original Practice Grant proposal had assumed. Some of the projects had specific goals, but as time went on the goals were not as relevant and were not always achievable, indicating that some of the grant's original objectives may have been unrealistic.

Over the period of the Practice Grant, three newsletters, Arizona Nursing Connections, were sent to a large number of registered nurses in the state describing activities of the various projects.

The Advisory Committee concluded its work by framing recommendations for AzNA. The committee recommended that:

1. The Board of Directors continues to support a periodic method of communication to the Arizona nursing community regarding projects affecting nursing within the state.

2. The Board of Directors work with the Arizona State Board of Nursing to facilitate the state board's continuing responsibility for regulating certified nursing assistants.

3. The Board of Directors takes leadership and initiative to address issues not covered by current projects, e.g., unlicensed assistive personnel.

In concluding the work of the grant, staff asked the contact person from each nursing project to respond to a set of questions. What follows are their responses. Please feel free to contact these people if you have questions about their respective projects.

COLLEAGUES IN CARING

What were the original goals of the project?

1. The establishment of regional and statewide systems and arrangements for nursing education (public and private) that feature and promote a clear ladder for educational advancement among all levels of nursing.

2. The establishment of corresponding arrangements among educational and services institutions aimed at nurturing and improving the performance of the current nursing workforce.

3. Establishing systems to gather and quantify dependable data on current workforce capacities - and to anticipate and forecast future requirements.

4. Serving as permanent regional forums for exploring evidenced-based policy measures addressed to current and future capacities in nursing care.