Evidence Supporting Need
Advancement of Formal
Nursing Education
Judith A. Burckhardt, PhD, RN Vice President
• 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 Historical Perspectives
• Currie et al (2005) Literature review of nursing
research on relationship between quality care, skills mix and staffing levels
Tri-Counci
• Need to advance education to enhance quality and safety
• Requires integration of evidence-based clinical knowledge and research
Tri-Council for Nursing
Consensus Policy Statement
knowledge and research
• Workplace needs teachers, scientists, primary care provider, nursing leaders
• Build a stronger, more educated workforce
• Integrate evidence-based research into clinical practice settings
• Engage in effective communication Healthcare Reform Needs
• Engage in effective communication • Improve leadership skills
• Coordinate patient care along a continuum
• Changing healthcare systems • New models of practice
• Need to thrive within complex healthcare environment
Nursing Education, a Life-Long Learning Process
environment
• Diverse and aging populations • Complex health problems
• Increase in chronic conditions Today’s Healthcare
Environments
• Increase in chronic conditions • Technology advancements
• New models of healthcare delivery • Predicted shortage of RNs
• Need to replace retiring nursing school faculty Needs of Healthcare
Environment
• Required to integrate clinical expertise with knowledge of community resources
• Incremental approach
• Move from novice to expert
• Academic progression from point of entry Journey into Nursing
Education
• Develop and strengthen competencies
• Education advancement with work experience = greater relevance for learner
• Deeper understanding of cultural, political, economic, and social issues
• Exposure to healthcare economics, health
informatics, health policy, leadership, and research Benefits of Advanced
Education
informatics, health policy, leadership, and research • Full partner on the multidisciplinary team
• Additional knowledge of physical, social sciences, and humanities
• Nursing research
• Public and community health Benefits of Completion Programs
• Public and community health • Nursing management
• Increased teamwork and coordination of patient care • Base for graduate education
• Increased critical thinking/ problem solving skills
• Case management skills
• Health promotion knowledge Benefits of Advanced
Education cont
• Health promotion knowledge • Broader scope of practice
• Ability to practice in variety of settings • Increased ability to be a change agent
• Shift to evidenced-based practice
• More sophisticated technologies and treatment modalities
• Increasing need to delegate and supervise care Changing Healthcare
Environment
• Increasing need to delegate and supervise care provided by UAPs
Research
• BSN nurses have a positive impact on mortality rates in Canadian hospitals
(Estabrooks, 2005) The Evidence
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 The Evidence cont
• 10% increase in the proportion of BSN nurses associated with 9 fewer deaths for every 1,000 discharged patients (Tourangeau et al, 2007)
• “…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 The Evidence cont
patient care” (Council on Physician and Nurse Supply, 2007)
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 The Evidence cont
decreased risk of patient death and failure-to-rescue by 5% (Aiken et al, 2008)
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
The Evidence cont
substantially fewer adverse outcomes for patients.” (Friese, 2008)
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 The Evidence cont
• The Magnet Recognition Program based on quality indicators and standards of nursing practice
• Models of clinical nursing practice based on indicators of professional excellence
– Advance degrees – Certifications
Differentiated Practice Models
– Certifications
– Clinical ladder programs
• Being at the right time and place in life
• Achieve a personal goal and ambition (job vs career) • Seeking a credible professional identify
Current Issues in Advanced Education
• Seeking a credible professional identify • Positive influence from colleagues
• Insufficient time • Lack of confidence
• Poor recognition for past educational and life experiences
Barriers to Advanced Education
experiences
• Equal treatment of nurses with ADN and BSN degrees • Previous negative experience in nursing school
• Collaboration and articulation between ADN and BSN completion programs
• Seamless transition from entry point to next educational level
• Institutions differentiate between educational levels What is Needed in Today’s
Educational System
• Institutions differentiate between educational levels of RNs (pay differentials, etc.)
• Develop mentorship programs for nurses advancing their education
• Offer recognition and application of past education
• Provide support (financial and psychological) to nurses continuing their educational journey
• Ensure relevant curricula in programs What is Needed in Today’s
Educational System cont
• Ensure relevant curricula in programs
• Cultivate culture of forward-thinking and educational mobility as norm
• Provide positive experiences during initial nursing program
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), 223-229.
Bureau of Labor Statistics. (2010). Occupational Outlook Handbook 2010-2011. Retrieved from http://www.bls.gov/oco/ocos083.htm.
Cronenwett, L., Sherwood, G., Barnsteiner, J., Disch, J., Johnson, J., Mitchell, P., Sullivan, D. & Warren, J. 2007. Quality and safety education for nurses.
References
P., Sullivan, D. & Warren, J. 2007. Quality and safety education for nurses. Nursing Outlook, 55(3), 122-131.
Currie, V., Harvey, G., West, E., McKenna, H. & Keeney, S. 2005. Relationship between quality of care, staffing levels, skills mix and nurse autonomy: literature review. Journal of Advanced Nursing, 51(1), 73-82.
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), 1145-1163.
Estabrooks, C. A., Midodzi, W. K., Cummings, G. C., Ricker, K. L., Giovanetti, P. (2005 March/April). The impact of hospital nursing characteristics on
References
P. (2005 March/April). The impact of hospital nursing characteristics on 30-day mortality. Nursing Research, 54(2), 72-84.
Institute of Medicine. 1999. To err is human. Retrieved from:
http://www.nap.edu/books/0309068371/html
Institute of Medicine. 2001. Crossing the quality chasm. Retrieved from:
Megginson, L. A. (2008). RN-BSN education: 21st century barriers and incentives. Journal of Nursing Management, 16,47-55.
Quality and Safety Education for Nurses. (2010). Project overview. Retrieved from http://www.qsen.org/overview.php
Tourangeau, A. E., Doran, D. M., McGillis Hall, L., O’Brien, Pallas, L. (2007 January). Impact of hospital nursing care on 30-day mortality for acute
References
January). Impact of hospital nursing care on 30-day mortality for acute medical patients. Journal of Advanced Nursing, 57(1), 32-41.
