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importance of quality improvement in nursing
the future of nursing practice
The purpose of this paper is to discuss, identify, and improve a quality improvement issue in nursing practice.
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Recommended: importance of quality improvement in nursing
Nursing has a long history of being integral to healthcare. However, without flexibility and continual development, it is at risk to stagnate and lag behind other professions. One change could have significant impact in averting, or some would say 'reversing', that negative trend: to raise and establish the minimum entry requirement for nursing practice. Over the years medicine has changed, society has changed, and culture has changed. These changes necessitate a malleable profession that adapts to better respond to increased demands, especially in regards to education. In light of the ever-evolving complexities and dynamics of the healthcare world, the minimum requirement for entry into nursing practice should be a baccalaureate degree.
The Institute of Medicine (IOM) recommended in a 2010 report that eighty percent of registered nurses (RNs) hold a baccalaureate degree by 2020. This is not a new goal, but rather one that has yet to be realized, despite being first recommended in 1965 by the American Nurses Association. Healthcare has made significant advancements since that time, but nursing standards to entry and licensing regulations have not reflected these changes (Hess, 1996). Students of both Associate Degree of Nursing (ADN) programs and Baccalaureate Degree (BSN) programs sit for the same national licensing exam, the NCLEX-RN. This is a disservice to the entire profession. Associate degrees are publicly perceived as 'technical' degrees. This influences public opinion on the competency and skill of all nurses (Jacobs, et al., 1998). In addition, the lack of differentiation of graduate degrees equates different educational levels and blurs expectations and requirements of the individual nurse. It also fost...
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...Nursing, 289-296.
Institute of Medicine. The Future of Nursing: Leading Change, Advancing Health . Washington, DC: The National Academies Press, 2011 . Retrieved May 5, 2014, from http://books.nap.edu/openbook.php?record_id=12956&page=R2
Jacobs, L., DiMattio, M., Bishop, T., & Fields, S. The Baccalaureate Degree In Nursing As An Entry-level Requirement For Professional Nursing Practice. Journal of Professional Nursing, 14, 225-233.
McEwen, M., Pullis, B., White, M., & Krawtz, S. Eighty Percent by 2020: The Present and Future of RN-to-BSN Education. Journal of Nursing Education, 52, 549-556.
Ridley, R. T. The Relationship Between Nurse Education Level And Patient Safety: An Integrative Review. Journal of Nursing Education, 47, 149-156. Retrieved May 3, 2014, from http://search.proquest.com.ezp- 01.lirn.net/docview/203930168/BCF3FA1B1B424006PQ/2?accountid=158614
The second key message focused on the recommendation that registered nurses receive greater levels of training and education. This message emphasized the need for nurses to enter the work force with a baccalaureate degree, or obtain it shortly afterwards. It also stressed the need more graduate nurses, specifically “nurse faculty and researchers at the doctoral level” (IOM, 2011, p. 164). Innovative solutions were devised to speak to nursing school capacity and curriculum in order to attain the IOM recommended goal of 80 percent of nurses holding a BSN by the year 2020.
The national shortage of Registered Nurses (RNs) has helped generate formidable interest in the nursing profession among people entering the workforce and those pursuing a career change. According to a report issued by the U.S. Department of Health and Human Service in 2002, the national population is continuing to grow and age and medical services continue to advance, so the need for nurses will continue to increase. They report from 2000 to 2020 the predicted shortage of nurses is expected to grow to 29 percent, compared to a 6 percent shortage in 2000. With the projected supply, demand, and shortage of registered nurses and nursing salaries ever-increasing, the nursing profession can offer countless opportunities. But first one must determine which educational path to pursue, Bachelor of Science in Nursing (BSN) or Associate Degree in nursing (ADN). Most will initially be educated at the associate degree level, even though the American Organization of Nursing Executives (AONE) has recommended a baccalaureate level as a minimal for entry-level nurses. With the expanding number of RN to BSN programs available there is always the option to further one’s education at a later date. The benefits for acquiring a BSN over an ADN include a better knowledge for evidence-based practice, an increased advantage for promotion, and the necessary gateway for higher education.
Taylor, D. (2008). Should the entry into nursing practice be the baccalaureate degree?. AORN Journal, 87(3), 611-620. doi: 10.1016/j.aorn.2007.07.006
The topic of "ADN versus BSN" is one that has plagued the nursing profession for decades. Does a nurse’s level of education really matter? Can ADN nursing graduates perform their duties as well as BSN graduates? These are the types of questions that continue to be debated by policymakers, educational organizations and associations, and the general public. This may be because nurses are now one of the least educated health care roles when compared to other health care professions that are now requiring bachelor degrees or higher for entry. A more likely reason is undoubtedly due to the growing body of evidence suggesting that BSN graduates are more prepared when entering the workforce than their ASN counterparts. These findings have made some hospitals decide to only hire BSN prepared graduates or higher. Linda Aiken, director of the center for health outcomes and research at Penn State, recently stated "the evidence base is growing, and a number of hospitals are acting on it” (Burling, 2010). If employers prefer BSN prepared nurses, why don’t more of them offer pay differentials or other incentives to return to school? The answer to that question is still unknown. The Veterans Administration (VA) is one exception. The VA leads the country in employing the most registered nurses according to the American Association of Colleges of Nursing (AACN, 2011). The VA made the decision a decade ago to establish the BSN as a requirement for new hires. The VA devoted $50 million in approximately five-years to help
Taylor, D. L. (2008). Should the Entry Into Nursing Practice be the Baccalaureate Degree? AORN Journal, 87(3), 611-619.
The history of nurses hadn’t developed until the nineteenth century. The first law was passed to require that nurses attain a license in 1938. After passing this law, the New York State began a movement to have certain programs to promise new standards in the field. Since the first schools were opened the training and criteria has changed tremendously. Education standards for nurses have improved in many different ways. Programs are an option throughout the country, and there are laws to back up the qualification and training standards for licensure. The nursing field is an important role as a part of the health care team, and can benefit one is so many ways. The history of nurses has changed from being a minor occupation to a major one. In today’s society people rely on nurses, doctors, and specialists more than ever. Nurses have brightened our future in the most beneficial way (Hopke 592).
Nursing, as a crucial part of the health care system, keeps evolving while dealing with an increasingly complex clinical situation that involves quality of patient care. Therefore, to successfully handle these scenarios, nursing needs to become more advanced, clinically and academically. A DNP degree is needed in this situation because according to Dunbar- Jacob, Navito & Khalil (2013), a DNP degree is considered to have more impact on nursing than a Master’s or Bachelor’s degree due to the advanced clinical education a DNP provides (p. 425). Hence, the DNP degree has an enormous impact in nursing practice especially in terms of improving clinical care, promoting leadership roles, and improving educational status.
Heller, B. R. , Oros, M. T., & Durney-Crowley, J. (2000). The future of nursing education: 10 trends to watch. Nursing and Health Care Perspectives, 21(1), 9-13.
Fields, S., Bishop, T., DiMattio, M., & Jacobs, L. (1998). The Baccalaureate Degree in Nursing As an Entry-Level Requirement for Professional Nursing Practice. Journal of Professional Nursing, 14, 225-233.
Nursing leaders nationwide believe that it is important for nurses with an Associate Degree to return to school to earn their Bachelor of Science in Nursing (BSN) education within 10 years of graduation from an Associate Degree program to keep their licensure. The reason why this bill is passed is because of patient safety. Nurses with Bachelor of Science in Nursing (BSN) have lower mortality rates in surgery department, less incidences, and better outcomes in the acute care settings which are heavily emphasized in the Affordable Care Act necessary for payment reimbursement (American Association of Colleges of Nursing, 2014). This bill A01977/S02533A was introduced in January 27, 2012 in the state of New York. At the same time the state of New Jersey also introduced similar bill A553. This author will represent one of the registered nurses with an Associate Degree who is going back for their BSN education to see the effectiveness of the bill on the healthcare system and therefore supports the bill.
There has been a drastic cut in both the Medicare and Medicaid reimbursement rates. According to Robert (2012), “cuts of more than $360 billion to Medicare and Medicaid will be made over the next 10 years. The focus of nursing needs to emphasize more on wellness care and prevention rather than acute care” (McNeal, G., 2012). Nursing practice will need to shift more towards community and population focused nursing. Baccalaureate prepared nurses are provided with a curriculum that includes both community health and leadership skills that are not included in the associate program. By encouraging associate’s degree nurses to obtain a bachelor’s degree in nursing, an increase in the awareness of the needs of the community and population may be seen. The IOM report has outlined the anticipated obstacles that healthcare will face if changes are not made. By allowing nurses to provide care within their full scope of practice, quality care may be provided at an affordable cost to the population. The use of advanced practice nurses in primary care may provide quality, access, and cost efficient healthcare to high-risk populations and possibly decrease hospital admission rates, thus lowering the overall cost of healthcare. If nurses partner with doctors and other healthcare providers, it may improve healthcare by providing seamless transitions (Institute of Medicine,
...uickly changing medical technology and environment. The bickering and infighting amongst nurses has to come to a stop if the profession is to move forward alongside the other medical professions. It is too late to take nursing back to the point of basic care of the 19th century now fulfilled by certified nurse aides. A nurse is the first and last person many people will ever see. They provide complex care, recognize symptoms and changes when the ever shrinking physician pool is not available, advocate for patient and families, and care deeply for their patients recovery. In this paper the author used past nursing history, current medical demands and advancements, and clinical patient outcomes to argue that the minimum education for a nurse should be a Baccalaureate degree in order to meet the Institute of Medicines goal of 80% of nurses should have BSNs by 2020.
The primary goal for nursing education is to obtain higher levels of education and training through an enhanced education system that supports continuous academic progression, this will deeply improve nursing education before and after nurses obtain their license to practice. The twenty-first century nurses need to accomplish more critical proficiencies to deliver complex quality care. The IOM made following recommendations for the future of nursing. An increase in the number of nurses with bachelor’s degree ...
In recent years, hospitals are seeking to hire more nurses with a bachelor’s degree rather than nurses who have obtained a certification or associate degree (ADN) in the United States. As of today, there are 2.8 million registered nurses that are employed in the work force and 61% of these population holds at least a BSN degree or received a higher education (AACN, 2015). The Future of Nursing reports that there will be an increase of 50% to 80% of BSN prepared nurses in the work force by 2020 (Kutney – Lee et al, 2014). A bachelor of science in nursing (BSN) is a program that requires 4 years of college education and associate degree in nursing (ADN) requires 2 years of college education to complete the program (Ciambelli, 2014).
Completing my Bachelor of Science in Nursing (BSN) has been one of my goals after I graduated from my Associate Degree in Nursing, and I said one of my goals because my ultimate goal is to become an Advance Practice Registered Nurse. It is the first time I am taking classes online and all my efforts will be in turn this journey into a positive experience to achieve my goals. One of the biggest challenge is to overcome the lack of time between my family and my work, but it is essential for my career to achieve the Bachelor Degree in Nursing, as well as personal development. Although I have had experience as a student, as a nurse, and as a leader, I would like to have more challenging job opportunities in my future. From my college experience,