Nursing doctorates in 4 schools’ plans

— Four Arkansas universities plan to add new terminal degrees in nursing to help address a shortage of health-care workers that’s expected to grow as more people gain access to insurance coverage.

The doctor-of-nursingpractice degree will also help meet needs for nursing faculty members and add qualified voices to discussions of changing clinical practices, payment methods and management structures throughout the health-care field, faculty members said. A terminal degree is the most advanced degree in a given field.

“It will take all four of our universities to meet the need in the state,” said Angela Schmidt, associate nursing dean at Arkansas State University-Jonesboro.

The Arkansas Higher Education Coordinating Board approved doctor-of-nursingpractice programs for the University of Arkansas for Medical Sciences and ASU on Friday in a meeting at ASU-Beebe’s Heber Springs campus.

The University of Central Arkansas and the University of Arkansas at Fayetteville plan to seek approval for their own doctor-of-nursing-practice programs in the next two months.

The four campuses formed a consortium in 2009 to explore offering the terminal degree in Arkansas, which is one of 12 states that don’t currently offer the program. That consortium later dissolved, and each university made plans to offer the degree under its own existing nursing program.

“For nurses, the educational programs of yesterday no longer meet their needs,” said Kathleen Barta, a professor of nursing at UA-Fayetteville.

Nurses with the terminal degree practice under the same licensure standards as nurse practitioners who have master’s degrees.

The doctorate allows them to treat patients, largely in primary-care settings, and to work as nurse anesthetists and nurse midwives, faculty members said.

While the programs are growing in popularity, fewer than 1 percent of nurses in the United States have doctorates, according to a fact sheet created by the four universities.

Schmidt said changing accreditation standards have fueled interest in the doctorate. The Commission of Accreditation for Nurse Anesthesia Educational Programs will not consider any new master’s degree programs in nurse anesthesia for accreditation beyond 2015, she said.

And adding health-care professionals with advanced credentials will help Arkansas face increasing demand for primary-care practitioners, especially in rural and underserved areas, said Matthew Hadley, a UAMS nursing professor who will lead the program there.

A study by the Arkansas Center for Rural Health estimates that there is shortage of 1,000 primary-care physicians in the state, a number that grows as older physicians retire.

More than 500,000 Arkansans live in areas with shortages of primary-care professionals, according to the U.S. Department of Health and Human Services.

The agency declares a shortage if providers in nearby areas are “overutilized, excessively distant, or inaccessible,” and there is a ratio of more than 3,500 residents per primary-care physician or a concentration of residents with higher-than-usual levels of medical needs.

And demand for healthcare professionals will grow when the Patient Protection and Affordable Care Act — largely upheld by the U.S. Supreme Court in June — extends coverage to hundreds of thousands of currently uninsured Arkansans when it is fully implemented in 2014, state public-health officials have said.

That number could reach about 500,000 if Arkansas opts to extend its Medicaid program eligibility to those with incomes of as much as 138 percent of the federal poverty line, a provision of the federal health-care law.

In addition to the advanced nursing degree, UAMS recently won approval of a physician-assistant program to help meet that need.

Along with a shortage of doctors and nurses comes a shortage of faculty to train future nurses, Barta said, adding that the new doctoral programs could create more professors to train nurses in bachelor’s degree programs.

And nurses with doctorates will add a special perspective to conversations about reworking medical payments, public-health initiatives and clinical management structures because they have a range of experiences, from bedside to diagnostic to academic and administrative, she said.

“They can make sure that the benefits of research actually get to patients,” Barta said.

Research by the Arkansas Department of Higher Education shows it’s not unusual to have multiple doctor-of-nursing-practice programs in one state.

There are five such programs in Alabama, three in Louisiana, two in Mississippi, five in Tennessee and six in Texas, the agency said.

Front Section, Pages 1 on 10/27/2012

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