Building an Evidence-Based Graduate Nursing Program: A Feasibility Study in Tennessee, USA

Transcription

1 Building an Evidence-Based Graduate Nursing Program: A Feasibility Study in Tennessee, USA Shu-li Chen, PhD, RN Mary Anne Modrcin, PhD, RN Sandra McGuire, EdD, RN Lincoln Memorial University Caylor School of Nursing Harrogate, Tennessee, USA

2 Research Purpose The purpose of this survey study was to examine the feasibility of starting a graduate nursing program at a new university service area in a rural area of USA. This is the forth feasibility survey completed by the Caylor School of Nursing (CSON) at the Lincoln Memorial University, Harrogate, Tennessee, USA, to examine feasibility of graduate nursing programs in rural areas.

3 Caylor School of Nursing (CSON) Mission Statement In agreement with the University s mission and goals, the Faculty of the Caylor School of Nursing strives to instill responsibility and high moral/ethical standards in the preparation of quality nurses, at multiple levels of nursing education, through superior academic programs at the undergraduate and graduate level. Specifically, the mission of the Faculty is to prepare nurses with the ASN, BSN, and MSN degree, to assist individuals, families, communities, and society as they adapt to changes in physiological needs, role function, self-concept, and interdependent relationships during health and illness.

4 Caylor School of Nursing (CSON) Mission Statement The Caylor School of Nursing seeks to respond to the needs of nursing education and healthcare in the surrounding communities by preparing nurses at multiple levels and by providing continuing education/professional development opportunities that are rooted in knowledge, research, and other scholarly activities.

5 Building an Evidence-Based Graduate Nursing Program 2004 Nurse survey 2005 Employer Survey 2007 Nurse Survey 2010 Nurse and Employer Feasibility Studies 2006 FNP 2008 CRNA 2011 PMHNP

6 Background 2004 Nurse Survey In 2004, Caylor School of Nursing at LMU conducted a survey of BSN prepared nurses (N=216) in the university service areas. The findings indicated a desire for an increase in advanced practice nursing education opportunities in Appalachia. 1) 80% desired a nurse practitioner gradate degree 2) 75% of which respondents wanted an FNP 3) The majority of them planned to start pursing this option within three years 4) The majority requested a program with both seat and webbased courses in addition to clinical experiences

7 Background 2005 Employer Survey In 2005, a Nurse Practitioner Employment Survey was distributed to selected regional health care facilities in the university service areas. 73% of the responding agencies reported utilization of NPs (preferring FNPs) and planned to continue using NPs within their agencies

8 MSN program established FNP in 2006 In 2006, the MSN degree program was first established to offer nurses further educational options and provide surrounding communities with Family Nurse Practitioners to meet identified health care needs. The MSN program, FNP concentration, provides a flexible format for either part-time or full-time nursing students currently working in area hospitals and health care facilities. The program allows full-time students to complete the MSN degree in a minimum of 17 months.

9 Background 2007 Nurse Survey Similar to the 2004 Surveys of RNs and RN students (N=216), the 2007 survey of nurses (N=176) continued to report the desire for an increase in advanced practice nursing education opportunities in Appalachia. 1) the 2007 survey reported that 75% desired to get an MSN with a Nurse Anesthesia focus. 2) two focus groups of LMU health care agencies met with LMU administration in Spring 2007 to discussion health care workforce needs. The number one need of all participants from LMU s service area was CRNAs

10 MSN program expanded NA in 2008 In 2008, the nurse anesthesia concentration (NA) was added to the MSN degree program. The nurse anesthesia concentration at LMU can be completed in 28 months of full-time study and requires 88 credit hours of graduate course work including six semesters of clinical practice. Full-time status is required. The Post-Master s Certificate option is available.

11 2010 Feasibility Survey This study required a one-time completion of the survey questionnaire, either by nurses or employers of nurses. The study included a convenience sample of 29 nurses and 14 potential employers of advanced nurse practitioners. It took approximately 5 minutes to complete each questionnaire. Participation was strictly voluntary. Completion of the questionnaire was used to verify participants consent to participate in the study.

12 Data Analysis Data collection were completed in the fall of Data analysis were completed in the spring of 2011 Descriptive statistics are used to better understand the needs and wants of local nurses and potential employers of nurses with graduate degrees.

13 Nurse Sample (n=29) Gender Nurses with Interest Nurses without Interest Total Female 17 (81%) 8 (100%) 25 (86%) Male 4 (19%) 0 (0%) 4 (14%) Education High School 3 (14%) 2 (25.0%) 5 (17%) AD/ASN 8 (38%) 1 (12.5%) 9 (31%) BSN 10 (48%) 4 (50.0%) 14 (49%) Graduate 0 (10%) 1 (12.5%) 1 (3%) Mean Age 30.24* 53.63* 36.69* * t=-4.5, p<.001

14 Findings about Degrees Are you interested in obtaining additional nursing education? Yes No Total 21 (72%) 8 (28%) 29 (100%) RN-to-BSN 4 (19%) 17 (81%) 21 (100%) MSN 13 (62%) 8 (38%) 21 (100%) DNP 6 (29%) 15 (71%) 21 (100%) PhD 2 (9%) 19 (91%) 21 (100%)

15 Findings about Specialty Interest Yes No Total What specialty are you interested in? Family Nurse Practitioner 15 (71%) 6 (29%) 21 (100%) Psychiatric Mental Health Nurse Practitioner 5 (24%) 16 (76%) 21 (100%) Pediatric Nurse Practitioner 5 (24%) 16 (76%) 21 (100%) Adult Health or Geriatrics 4 (19%) 17 (81%) 21 (100%) Women s Health 3 (14%) 18 (86%) 21 (100%) Certified Registered Nurse Anesthetists 1 (5%) 20 (95%) 21 (100%) Nursing Administrator 1 (5%) 20 (95%) 21 (100%) Critical Care Nurse Specialist 1 (5%) 20 (95%) 21 (100%)

16 Findings about Application Interest Yes No Total What specialty would you apply for? Family Nurse Practitioner 14 (67%) 7 (33%) 21 (100%) Psychiatric Mental Health Nurse Practitioner 4 (19%) 17 (81%) 21 (100%) Pediatric Nurse Practitioner 5 (24%) 16 (76%) 21 (100%) Adult Health or Geriatrics 4 (19%) 17 (81%) 21 (100%) Women s Health 5 (24%) 16 (76%) 21 (100%) Certified Registered Nurse Anesthetists 1 (5%) 20 (95%) 21 (100%) Nursing Administrator 1 (5%) 20 (95%) 21 (100%) Critical Care Nurse Specialist 1 (5%) 20 (95%) 21 (100%)

17 Findings about interest in LMU About 1-2 years About 2-5 years About 6 or more years later Total When would you like to begin your nursing program? 14 (67%) 7 (33%) 0 (0%) 21 (100%)

18 Findings about start time If LMU were to offer a Family Nurse Practitioner (FNP) program in Kingsport, would you apply? Yes No Not Sure 10 (48%) 6 (29%) 5 (24%) Total 21 (100%)

19 Findings about location Kingsport Knoxville Johnson City Total At what location would you prefer to attend classes? 17 (81%) 3 (14%) 1 (5%) 21 (100%)

20 Findings about program length What time frame do you prefer to complete this degree? Within 12 months Between 12 & 18 months Between 18 months & 2 years No Preference 1 (5%) 9 (43%) 7 (33%) 4 (19%)

21 Findings about program delivery Classroom Courses Online Courses Combined Courses Total What delivery method do you prefer to obtain this degree? 6 (29%) 6 (29%) 13 (62%) 21 (100%)

22 Findings about class hours Daytime Classes Evening Classes Weekends Block scheduling What time of day would you prefer for class instruction? 13 (62%) 9 (43%) 5 (24%) 5 (24%)

23 Findings about employer s interest Does your facility utilize nurses with graduate degrees? Would your facility hire a nurse practitioner? Would your facility hire a new graduate as a nurse practitioner? Yes No Total 10 (71%) 4 (29%) 14 (100%) 12 (86%) 2 (14%) 14 (100%) 12 (86%) 2 (86%) 14 (100%)

24 Specifics about employer's Interest Yes No Total What position do you have for them? Family Nurse Practitioner 11 (79%) 3 (21%) 14 (100%) Psychiatric Mental Health Nurse Practitioner 1 (7%) 13 (93%) 14 (100%) Pediatric Nurse Practitioner 2 (14%) 12 (86%) 14 (100%) Adult Health or Geriatrics 2 (14%) 12 (86%) 14 (100%) Women s Health 6 (43%) 8 (57%) 14 (100%) Other 2 (14%) 12 (86%) 14 (100%)

25 Findings about employer s need Full-time (32-40 hours per week) Part (less than 32 hours per week) No need at present time Total Would your facility need a nurse practitioner? 7 (50%) 1 (7%) 6 (43%) 14 (100%)

26 Difference between nurses and employers by Pearson Chi-Square Family Nurse Practitioner Nurses Employers Psychiatric Mental Health NP Nurses Employers Pediatric Nurse NP Nurses Employers Yes No p value 24 (77.4%) 14 (66.7%) 10 (100%) 4 (12.9%) 4 (19.0%) 0 (0%) 7 (22.6%) 5 (23.8%) 2 (20%) 7 (22.6%) 7 (33.3%) 0 (0.0%) 27 (87.1%) 17 (81.0%) 10 (100.0%) 24 (77.4%) 16 (76.2%) 8 (80.0%) 0.04* * Person Chi-square=4.3, p<.05

27 Difference between nurses and employers by Pearson Chi-Square Adult Health or Geriatrics Nurses Employers Women s Health Nurses Employers Yes No P value 6 (19.4) 4 (19.0%) 2 (20.0%) 11 (35.5%) 5 (23.8%) 6 (60.0%) 25 (80.6%) 17 (81.0%) 8 (80.0%) 20 (64.5%) 16 (76.2%) 4 (40.0%) * * Person Chi-square=3.9, p<.05

28 SWOT Analysis Strengths (S) Included both nurses and employers Allow comparisons by using same rating scale Including open-ended questions Weaknesses (W) Small sample size (Nurse N=29; Employer N=14) Convenience sample Single healthcare facility Low response rates among employers (36.8%)

29 SWOT Analysis (continued) Opportunities (O) Preparing nurses at the graduate level Responding respond to the needs of nursing education and healthcare in the surrounding communities by preparing nurses at graduate level Threats (T) Recent economic recession in USA Several existing FNP programs in the nearby areas Newly launched FNP program in the service area

30 Why not FNP? Four main reasons for us not launching our new FNP program in the new service area Small Sample Size Single Survey Site Recent economic recession Newly launched FNP program nearby

31 Program expanded further PMHNP in 2011 As we continued to live up to our mission in seeking to respond to the needs of nursing education and healthcare in the surrounding communities, the school received phone calls and inquiries for Psychiatric Mental Health Nurse Practitioner. In January 2011, the Psychiatric Mental Health Nurse Practitioner was added to our MSN degree program. The PMHNP concentration at LMU can be completed in 12 months of full-time study and requires 41 credit hours of graduate course work including 500 clinical hours. The Post Master s Certificate option is available.

32 Implications The knowledge gained may also allow nurse researchers to utilize this knowledge to plan, implement, and support culturally sensitive educational initiatives for graduate nursing programs. Understanding gained from this survey study will aid nurse educators and clinicians in identifying systematic ways to support nursing education through graduate studies. Lastly, the survey data are important for approval and accreditation processes and should be incorporated in the systematic plan for evaluation of graduate nursing programs.

33 Program Develop Cycle Mission Outcome Evaluation Feasibility Studies Program Development Focus Groups SWOT Analysis

34 Conclusion The findings from this feasibility study provides information about the most effective and efficient ways to design, development, implement, and evaluate a graduate nursing program for nurses serving rural communities. Conducting such feasibility studies assists the educational institution in establishing if a need for educational programs exists in an area before proceeding with instituting a program.

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