North Carolina

The North Carolina Action Coalition serves as the driving force transforming health care through nursing in our state. Working with diverse stakeholders to create and model innovative solutions with nurses leading the way, the North Carolina Action Coalition aims to improve the health and health outcomes of our population.



Where North Carolinians get health care and how health care is delivered requires a highly educated nursing workforce.  Because nurses play a critical role in delivering high quality care, our goal is to increase the number of nurses with higher degrees to make sure they are prepared and ready to provide 21st century care.


We are implementing a dual admission BSN educational track between community colleges and universities across North Carolina. Through the Regionally Increasing Baccalaureate Nurses (RIBN) Project, we are creating a dual admission, four year educational track between community colleges and universities as an economically-feasible pathway to increasing the proportion of BSN-prepared nurses in North Carolina. This program is especially attractive to students in the more rural areas of the state.  In 2014, the first cadre of RIBN students will graduate, by which time more than 20 community colleges and seven universities will be admitting students into this new seamless educational pathway.  

Efforts are now underway to implement a common course catalog for general education and nursing prerequisite requirements across all state-funded universities to facilitate RN-BSN education for practicing nurses.


Nurses bring a unique, important perspective to health care, higher education, business and policy leadership.  Yet at the moment, nurses are underrepresented as leaders in all industries, in North Carolina and across the country.



We are developing a ”leadership incubator” to facilitate leadership development, a strategic process to increase nurses’ participation on organizational boards, and a unique mentorship initiative. In October 2012, the first of a series of three conferences will be launched as a pilot project to develop leadership skills in nurses across North Carolina.  Themes for the conferences are “Surviving the Health Care System,” “Thriving in the Health Care System,” and “Transforming the Health Care System,” with an overarching emphasis upon the leadership potential and responsibility of every nurse and empowerment to lead effectively.   Faculty have committed to replicate these conferences across the state.

We also are providing formal education for nurses to facilitate effective service on organizational boards via a newly designed course that will be taught for the first time at East Carolina University this fall. The course will be part of the nursing curriculum and will also be made available as a continuing education offering.  Additionally, a list currently is being compiled that will identify and recommend nurses as strong candidates for board membership.  The list will be shared with various organizations for consideration as they rotate or otherwise include new members.


Both federal and state regulations can hamper access to quality care by advanced practice registered nurses. Ensuring access to care is especially important to North Carolinians given our rising need for primary care coupled with our aging population.


We are looking at how we can improve North Carolina laws and statutes to better meet patients’ needs.  This includes law and rule changes, such as allowing NPs to sign death certificates, write for refills on Schedule III drugs and streamlining the approval to practice process by removing the physician signature requirement.  We also are working to change the rule within the NC State Board of Nursing to include a definition of Advanced Practice Registered Nurse.

The Practice and Education Committee of the Board of Nursing has spent most of 2012 exploring potential barriers for the registered nurse. Recommendations will be issued by the end of the year.

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.


To foster collaboration, we are developing and deploying best practices in team/interprofessional practice models. We want nurses to practice according to their level of education and licensure to improve and transform health care.


North Carolina’s population is becoming increasingly more diverse, and many residents have unique health care needs. The nursing workforce must evolve to reflect these changing dynamics.


North Carolina will be focusing on increasing the diversity of the RIBN student applicants through joint efforts with the NC Area Health Education Centers Health Careers and Workforce Diversity program.


To prepare for the increasing demand for health professionals, consistent data on both practicing health professionals and students must be available for adequate workforce planning.


In North Carolina, we are working with our board of nursing to begin collecting data in 2012 on students and licensees related to the Regionally Increasing Baccalaureate Nurses (RIBN) Project, for longitudinal tracking purposes.

Additionally, we are working with the North Carolina Board of Nursing, which revised new application and renewal processes to capture a minimum nurse supply data set. Our workforce data will be submitted directly to the National Council of State Boards of Nursing for coordination with the forum of state workforce centers and the U.S. Health Resources and Services Administration.

The Board of Nursing prepared “North Carolina Trends in Nursing Education: 2006-2011” to examine characteristics of the nursing student population, types of programs in which students are enrolled, and faculty qualifications and vacancy rates. Access the report here.



Polly Johnson, CEO, Foundation for Nursing Excellence

Diana Hatch, Past State President, AARP North Carolina

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