Evidence Supporting Need Advancement of Formal Nursing Education. Judith A. Burckhardt, PhD, RN Vice President Kaplan University School of Nursing

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1 Evidence Supporting Need Advancement of Formal Nursing Education Judith A. Burckhardt, PhD, RN Vice President Kaplan University School of Nursing

2 Historical Perspectives Institute of Medicine Report (IOM) To Err Is Human (1999) IOM Report Crossing the Quality Chasm (2001) Currie et al (2005) Literature review of nursing research on relationship between quality care, skills mix and staffing levels

3 Tri-Counci Tri-Council for Nursing Consensus Policy Statement Need to advance education to enhance quality and safety Requires integration of evidence-based clinical knowledge and research Workplace needs teachers, scientists, primary care provider, nursing leaders

4 Healthcare Reform Needs Build a stronger, more educated workforce Integrate evidence-basedresearch into clinical practice settings Engage in effective communication Improve leadership skills Coordinate patient care along a continuum Develop better systems and use of technology

5 Nursing Education, a Life-Long Learning Process Changing healthcare systems New models of practice Need to thrive within complex healthcare environment Current approaches to reducing medical errors

6 Today s Healthcare Environments Diverse and aging populations Complex health problems Increase in chronic conditions Technology advancements

7 Needs of Healthcare Environment New models of healthcare delivery Predicted shortage of RNs Need to replace retiring nursing school faculty Required to integrate clinical expertise with knowledge of community resources

8 Journey into Nursing Education Incremental approach Move from novice to expert Academic progression from point of entry Develop and strengthen competencies Education advancement with work experience = greater relevance for learner

9 Benefits of Advanced Education Deeper understanding of cultural, political, economic, and social issues Exposure to healthcare economics, health informatics, health policy, leadership, and research Full partner on the multidisciplinary team

10 Benefits of Completion Programs Additional knowledge of physical, social sciences, and humanities Nursing research Public and community health Nursing management Increased teamwork and coordination of patient care Base for graduate education

11 Benefits of Advanced Education cont Increased critical thinking/ problem solving skills Case management skills Health promotion knowledge Broader scope of practice Ability to practice in variety of settings Increased ability to be a change agent

12 Changing Healthcare Environment Shift to evidenced-based practice More sophisticated technologies and treatment modalities Increasing need to delegate and supervise care provided by UAPs Multicultural and aging patient population

13 The Evidence Research BSN nurses have a positive impact on mortality rates in Canadian hospitals (Estabrooks, 2005)

14 The Evidence cont Research BSN nurses have a positive impact on lowering mortality rates Hospitals with higher proportion of BSN nurses tend to have lower 30-day mortality rates 10% increase in the proportion of BSN nurses associated with 9 fewer deaths for every 1,000 discharged patients (Tourangeau et al, 2007)

15 The Evidence cont a growing body of research supports the relationship between the level of nursing education and both the quality and safety of patient care (Council on Physician and Nurse Supply, 2007)

16 The Evidence cont Research Surgical patients have a substantial survival advantage if treated in hospitals with higher proportions of BSN nurses 10% increase in proportion of BSN nurses results in a decreased risk of patient death and failure-to-rescue by 5% (Aiken et al, 2008)

17 The Evidence cont Research BSN nurses are linked with lower mortality and failure-to-rescue rates Moving to a nurse workforce in which a higher proportion of staff nurses have at least a baccalaureate-level education would result in substantially fewer adverse outcomes for patients. (Friese, 2008)

18 The Evidence cont Research Magnet designation based on 5 model components structured to focus healthcare organizations on achieving superior performance as evidenced by outcomes The Magnet Recognition Program based on quality indicators and standards of nursing practice

19 Differentiated Practice Models Models of clinical nursing practice based on indicators of professional excellence Advance degrees Certifications Clinical ladder programs Supportive healthcare systems

20 Current Issues in Advanced Education Being at the right time and place in life Achieve a personal goal and ambition (job vs career) Seeking a credible professional identify Positive influence from colleagues Finding a user-friendly program (Megginson, 2008)

21 Barriers to Advanced Education Insufficient time Lack of confidence Poor recognition for past educational and life experiences Equal treatment of nurses with ADN and BSN degrees Previous negative experience in nursing school (Megginson, 2008)

22 What is Needed in Today s Educational System Collaboration and articulation between ADN and BSN completion programs Seamless transition from entry point to next educational level Institutions differentiate between educational levels of RNs (pay differentials, etc.) Develop mentorship programs for nurses advancing their education Link between formal education and clinical practice

23 What is Needed in Today s Educational System cont Offer recognition and application of past education Provide support (financial and psychological) to nurses continuing their educational journey Ensure relevant curricula in programs Cultivate culture of forward-thinking and educational mobility as norm Provide positive experiences during initial nursing program

24 References Aiken, L. H., Clarke, S. P., Sloane, D. M., Lake, E. T., Cheney, T. (2008 May). Effects of hospital care environment on patient mortality and nurse outcomes. Journal of Nursing Administration, 38(5), Bureau of Labor Statistics. (2010). Occupational Outlook Handbook Retrieved from Cronenwett, L., Sherwood, G., Barnsteiner, J., Disch, J., Johnson, J., Mitchell, P., Sullivan, D. & Warren, J Quality and safety education for nurses. Nursing Outlook, 55(3), Currie, V., Harvey, G., West, E., McKenna, H. & Keeney, S Relationship between quality of care, staffing levels, skills mix and nurse autonomy: literature review. Journal of Advanced Nursing, 51(1),

25 References Friese, C. R., Lake, E. T., Aiken, L. H., Silber, J. H., Sochalski, J. (2008 August). Hospital nurse practice environments and outcomes for surgical oncology patients. Health Services Research, 43(4), Estabrooks, C. A., Midodzi, W. K., Cummings, G. C., Ricker, K. L., Giovanetti, P. (2005 March/April). The impact of hospital nursing characteristics on 30-day mortality. Nursing Research, 54(2), Institute of Medicine To err is human. Retrieved from: Institute of Medicine Crossing the quality chasm. Retrieved from:

26 References Megginson, L. A. (2008). RN-BSN education: 21st century barriers and incentives. Journal of Nursing Management, 16, Quality and Safety Education for Nurses. (2010). Project overview. Retrieved from Tourangeau, A. E., Doran, D. M., McGillisHall, L., O Brien, Pallas, L. (2007 January). Impact of hospital nursing care on 30-day mortality for acute medical patients. Journal of Advanced Nursing, 57(1),

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