This column addresses the results of the environmental scan, a major input of the Nursing Professional Development (NPD) Practice Model. Environmental scanning is defined as the "process of systematically monitoring an organization's internal and external environments for the earliest signs of opportunities and threats that may reveal a potential professional practice gap" (Harper & Maloney, 2016, p. 60). Engaging in this process helps the NPD practitioner plan for potential opportunities and changes in NPD practice based on economic, healthcare, political, societal, and technological trends. These trends, outlined in the 2016 Nursing Professional Development: Scope and Standards of Practice, 3rd Edition (Harper & Maloney, 2016) include the workforce, practice environment, organization, technological influences, political influences, and professional development practice changes. The purpose of this column is to inform readers of these trends with potential role implications for the NPD practitioner.
WORKFORCE
Anticipated workforce issues that may impact NPD practitioners include "multiple generations in the workforce; loss of the expertise with baby boomer retirement; increased diversity in nursing; anticipated growth in the shortage of healthcare professionals; increased demand for transition into practice programs and mandated nurse residencies for licensure; progressive education expectations for nurses; and increasing emphasis on nursing certifications for employment and retention" (Harper & Maloney, 2016, p. 26).
Role implications for the NPD practitioner:
* As a learning facilitator, include nurses from multiple generations in planning and implementing professional development activities.
* As a leader, use your influence and recommend more flexible schedules to retain baby boomer nurses for their expertise and mentoring of less experienced nurses.
* As a partner for practice transitions, influence decision makers to implement (or continue) a nurse residency program at your organization, then seek accreditation for the program.
* As a mentor, encourage nurses and set a goal (Why not 100%?) for NPD colleagues in your setting to obtain NPD specialty certification; encourage nurses to pursue a doctoral degree (if applicable, this goes for you too!).
PRACTICE ENVIRONMENT
For the NPD practitioner, 17 practice environment issues have been identified in the new scope and standards. Some of these issues include the following: the promotion of healthy workplace environments, nurses functioning within the full scope of practice (not just advanced practice nurses) including fee for services, a focus on interprofessional teamwork and team competence, a transition from a focus on the clinical setting to the provision of nursing services across the continuum of care, emphasis on the integration of decision support systems and electronic health records, 90% of clinical decisions to be evidence-based by 2020, developments in genetics and genomics, and demonstration of NPD's impact on patient outcomes (Harper & Maloney, 2016). Two more topics to consider adding to this list are opioid abuse and legalization of cannabis.
Role implications for the NPD practitioner:
* As a leader and a mentor, role model a culture of respect with no tolerance for any type of bullying.
* As a partner for practice transitions collaborate with interprofessional colleagues across care settings to foster smooth transitions across the continuum of care.
* As a champion for scientific inquiry, continually ask "Is this evidence-based?" when dealing with clinical decisions; use scientific, standard metrics to collect and analyze data related to outcomes.
* As an advocate for NPD specialty, demonstrate and disseminate the influence of NPD to improve outcomes both within your organization and externally.
ORGANIZATION
Specific trends related to the organization for which the NPD practitioner must be alert are "identification of optimal nursing professional development organizational structures (centralized vs. decentralized reporting structure); increased organization complexity due to mergers, acquisitions and expansions; and ongoing challenges in healthcare funding and reimbursement" (Harper & Maloney, 2016, p. 27).
Role implications for the NPD practitioner:
* As a leader, assess NPD services/activities across your individual organization and healthcare system to ensure alignment with organizational priorities.
* As a leader, use your influence and recommend consolidating services where and when appropriate to improve cost and efficiency (e.g., rather than several hospitals offering the same review course at different times and locations, collaborate for one event).
* As a leader, share evidence with administrators that demonstrates the value and return on investment for the professional development of nurses (Opperman, Liebig, Bowling, Johnson, & Harper, 2016).
TECHNOLOGICAL INFLUENCES
The technological influences identified for NPD practice are "increasing emphasis on privacy of patient data; the use of mobile devices to communicate and retrieve information; the availability of large complex data sets; proliferation of social networking; proliferation of personal electronic devices; increasing use of virtual health programs; transition to connected health; and technology driven care decisions diminishing individual acceptance of accountability" (Harper & Maloney, 2016, p. 27).
Role implications for the NPD practitioner:
* As a leader, identify what data are (and are not) being collected within your NPD practice and setting (microsystem, mesosystem, and macrosystem) as they relate to NPD practice, nursing problems, interventions (education), and outcomes. Then ask, "What is the meaning of these data? How are they being used? Are they being used to improve practice?"
* As a leader, be an active member of the health information technology team and contribute to strategic planning and implementation of data-driven decisions.
* As a change agent, engage with nurse informaticists to advance nursing-sensitive quality eMeasures, standardized electronic quality indicators that promote consistent measurement (HIMSS, 2015; National Quality Forum, n.d.).
* As an advocate for NPD specialty, implement standardized and accepted terminology and metrics for tracking outcome data.
* As a champion for scientific inquiry, urge colleagues to use research-based, standardized assessment scales and instruments to promote interoperability of data.
POLITICAL INFLUENCES
Political influences that may impact NPD practice are "increases in number of insured individuals seeking healthcare service; impacts of a global economy; increasing scrutiny of healthcare outcomes and pay for performance/value based payment model; implications of the federal government as primary payor for healthcare; and growing costs of healthcare" (Harper & Maloney, 2016, p. 27).
Role implications for the NPD practitioner:
* As a leader and an advocate for NPD practice, influence decisions of others with the use of credible data.
* As a change agent, access and apply the resources in legislative advocacy toolkits; write letters to those in positions of authority (e.g., congressman) in support of legislative issues that "protect the public" (for the "Web-Based Resource for Public Policy Advocacy" go to http://www.nln.org/docs/default-source/advocacy-public-policy/web-based-resource).
* As a learning facilitator, register for "E-Mail Alerts" for nursing and public policy issues provided by the American Nurses Association. To register, go to https://www.smartbrief.com/signupSystem/subscribe.action?pageSequence=1&briefNam.
PROFESSIONAL DEVELOPMENT PRACTICE CHANGES
The environmental scan identified 13 professional development practice change issues expected to impact NPD practice. For ease in reading, they are organized here as educational, financial, and other.
Educational changes include increasing interprofessional continuing education; providing just-in-time training and rapid cycle development of education; deemphasizing traditional classroom-based learning; implementing evidence-based teaching and learning strategies; using technology, including simulation, in continuing education and conducting rigorous multisite research related to NPD practice; and promoting accreditation and funding of practice transition programs for newly licensed nurses (Harper & Maloney, 2016). Financial changes include "promoting learning as an investment in human capital and cost avoidance versus an expenditure" and "demonstrating NPD return on investment (ROI)" (Harper & Maloney, 2016, pp. 27-28).
Other changes for NPD practice include "succession planning for future nurse leaders; developing nurses to serve on advisory and governing boards of health-related corporations and non-profit organizations; preparing nurses for the political arena (local, state and federal); and retooling the workforce to enhance nurses' ability to practice not only in acute care but across the entire continuum of care" (Harper & Maloney, 2016, p. 27).
Role implications for the NPD practitioner:
* As a leader, use your voice and presence to influence health care by joining an advisory or governance board and encourage colleagues to do the same (to get started, register at http://nursesonboardscoalition.org).
* As a leader, provide evidence for the return on investment of NPD activities (Opperman et al., 2016).
* As a leader and a learning facilitator, increase the number of interprofessional continuing education activities (for Core Competencies for Interprofessional Collaborative Practice, go to http://www.aacn.nche.edu/education-resources/ipecreport.pdf).
* As a leader and a mentor, create and participate in succession planning programs for other NPD practitioners.
* As a learning facilitator, increase blended learning strategies in virtual and physical spaces; use active and interactive activities, affective computing (e.g., virtual assistant) and robotics, augmented reality (digital information and spaces in real world), and virtual reality; read and apply the simulation information provided in the Journal for Nurses in Professional Development Simulation column.
SUMMARY
This column addressed the current and future issues, innovations, and trends as outlined in the Nursing Professional Development: Scope and Standards of Practice, 3rd Edition (Harper & Maloney, 2016), along with role implications for the NPD practitioner. Because the NPD practitioner is in a pivotal position to influence these issues and trends, the question is, "What can and will you do to help your organization through these changes?"
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