The Delaware Action Coalition is the driving force transforming health care through nursing in our state. Understanding that Delaware has specific health care challenges and needs, we are working with diverse stakeholders to create and model innovative solutions with nurses leading the way.


If nurses are to be as effective as possible in helping to provide high-quality patient care to diverse populations in Delaware, they will need to be better prepared as care becomes more complex and moves into the community.


Delaware will advance pathways for a diverse nursing workforce to achieve higher levels of education and training through an improved education system that promotes seamless academic progression, ensuring that nurses can deliver high-quality, patient-centered care. One of the ways that this is being accomplished is through strong articulation agreements between the community college system and a variety of colleges and universities both within the state borders and in surrounding states. Delaware is a small state and has one community college statewide which supports access to diverse populations. The community college is in the process of aligning all nursing curricula which in the past have been separate. The end result is attainment of one of the key goals of the IOM-streamlining academic progression and an increase in the proportion of nurses with a baccalaureate degree by the year 2020. 


Nurses bring a unique, important perspective to health care, higher education, business and policy discussions. Faced with Delaware’s significant health care challenges, nurses at all levels must step up, and contribute their valued perspective.  



We will enhance interdisciplinary communication between nursing leaders working in healthcare organizations, higher education institutions, private businesses and legislative arenas.  We will bring their unique perspectives together focused on collaboratively engaging and developing nurses at all levels into future leaders.

The Delaware Nurses Association (DNA) historically has served as a communication hub for nursing leadership in Delaware.  The DNA understands the value of open ongoing communication between nursing leadership and that building allies is critical to providing opportunities for nurses to take on leadership roles.  By working collaboratively with the Delaware Organization of Nurse Leaders (DONL) the DNA provides a connection to resources that allow nurses to apply leadership principles designed to improve nursing practice.  The leadership of the DNA and DONL will continue to work collaboratively to identify mechanisms which will strengthen the development of new nursing leaders in Delaware.


Delaware’s population is growing, as is the shortage of primary care providers. From 2000-2010 Delaware’s population grew by 14.6%.  This trend is projected to continue, making Delaware the sixth most densely populated state. Approximately 66% of Delaware is federally designated as a shortage area for primary care.  Outdated laws and regulations must be modernized so that nurses can provide the care that they are educated and trained to deliver.


Delaware Advanced Practice Nurse (APN) statutory language and associated rules and regulations have been reviewed by the Delaware State Board of Nursing- APN Committee.  The APN committee drafted revisions required to bring the current statutory language into alignment with the APRN consensus model.  A strategic plan was implemented to educate APNs about the consensus model and simultaneously provide forums to receive feedback.  Town-hall meetings were held in all three counties and approximately 10% of the APNs licensed in Delaware attended.  The next phase is providing the information at all the Delaware Hospital systems for APNs and nursing leadership. Moving forward, the APN committee will focus on the following three issues: Change Title to APRN; Remove collaborative practice agreement requirement; Creation of an APRN Advisory Committee reporting directly to the State Board of Nursing. The overarching goal is to remove practice barriers thus improving access to primary care for the citizens of Delaware.

Interprofessional Collaboration

To ensure high quality, patient-centered care, nurses, physicians and other health professionals must collaborate in education and practice, and across all health care settings.



The Delaware Action Coalition is collaborating with the Delaware Healthcare Association (DHA) as a co-lead. The DHA represents 6 acute care hospitals throughout Delaware which are the largest employers of professional nurses. Recently, DNA moved its offices within the Delaware Academy of Medicine. The Delaware Academy of Family Physicians and the American Academy of Pediatrics, Delaware Chapter are also housed within DAM. This provides a unique opportunity for collaborative outreach and education. The membership of the Delaware Academy of Medicine includes medical providers of all specialties and career levels including medical librarians, practice administrators, and public health practitioners.


Delaware’s population is becoming increasingly more diverse, and many residents have unique health care needs. Available data continues to reflect the majority of nurses in Delaware are white/non-Hispanic. The nursing workforce needs to reflect the diversity of the population that is served.


The Delaware Action Coalition is working with colleagues throughout the state to communicate the value of diversifying the nursing workforce to reflect the state’s population.  The Delaware Action Coalition is also looking to other successful programs as models for implementation.  For example, California offers the Minority Nursing Faculty Scholarship Program to help increase the number of nurse educators from underrepresented groups. The Robert Wood Johnson Foundation offers the New Careers in Scholarship Program (NCIN) which has financially supported programs of diversification at schools of nursing in North Carolina and Texas.


Effective deployment of the health care workforce requires information – data to identify, quantify and qualify the types of skills and health providers needed in the future. To date, major gaps exist in the workforce data.


The Delaware Action Coalition is working in collaboration with the Delaware Board of Nursing for data collection. The Board of Nursing has been participating in the National Council of State Boards of Nursing (NCSBN) Data Integrity project since January 2011.  All active licensees’ records were updated to include date of birth, social security number, education level, and exam information in the licensure database.  The Board staff is currently updating inactive licensee records.  This information is uploaded daily to the national Nursys database from the NCSBN. Nursys provides online verification to a nurse requesting to practice in another state and nurse license lookup reports to employers and the general public. In addition, disciplinary board orders are attached to licensee records in Nursys and they are also available on the Board of Nursing website.




Sarah Carmody, Executive Director, Delaware Nurses Association

Pamela Zickafoose, Executive Director, State Board of Nursing 

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