Entry Level into Practice Michelle RoweNURS 450Ferris State University
Objectives • You will be able to identify the difference in education levels one must pass to be eligible for the NCLEX exam to obtain licensure. • You will have increased knowledge if patient outcomes are affected by the nurse’s education level. • You will have increased knowledge of which nursing organizations support and promote entry level nurses to have bachelor degrees.
Question at Issue • What education level is best for nurses to obtain prior to entering the workforce?
Outline • Introduction • What is the best education level for an entry level nurse? There are 3 levels of education which all lead to the same licensure. • Theory Base • Benners’ Theory of From Novice to Expert • Rogers’ Theory of Diffusion of Innovation • Assessment of the Healthcare Environment • Studies show that patients who were cared for by a BSN nurse have a lower risk for complications and errors.
Outline continued • Inferences and Implications/Consequences • Patient outcomes increase while being treated by a higher educated nurse. • There is a connection between education and clinical judgment. • Recommendation for Quality and Safety Improvements • Nurses will possess attitudes showing they acknowledge their own potential to contribute to effective team functioning by participation in lifelong learning and striving to advance their education. • Nurses will gain skills in identifying gaps between local and best practice by extending their education level.
Questions to Consider • Would you rather have a nurse who has more experience or more education care for you? Why? • Does your current facility have criteria for nurses and their education level upon hiring? • What educational level do you feel should be the minimal requirement for nurses? Why?
Introduction • ADN vs. BSN • Studies support higher education • IOM supports 80% of RNs to have BSNs by 2020 (DeBasio & Fetsch, 2011)
Nursing History • Many societies chose women to fill the role of caregiver • No formal education • Oral traditions passed from generation to generation • Observations of others caring for the sick • System of trial and error • Florence Nightingale: nursing school (Egenes, nd)
Diploma of Nursing • Oldest and most traditional type of nursing education in the United States • Education primarily in the hospital setting • Graduates receive a diploma opposed to a degree • A strong emphasis on clinical experiences in direct patient care • Able to sit for the NCLEX • In 2004 there were only 68 diploma programs in the US (White, 2001)
Associate Degree • Community Colleges- 2 year program • General education courses completed prior to core nursing classes • Combines classroom with skills lab and clinical experience • Able to sit for the NCLEX (White, 2001)
Bachelor Degree • More in-depth course work than the associates degree • Traditional 4 year university • RN-BSN program • Accelerated BSN • Able to sit for the NCLEX or need to have a RN license (AACN, 2012)
Nursing Theory • Describe, predict, and explain the phenomenon of nursing • Helps us to decide what we know and need to know (Current Nursing, 2012)
From Novice to Expert • Dr. Patricia Benner • 5 levels of nursing experience • Novice • Advanced Beginner • Competent • Proficient • Expert (Current Nursing, 2011)
Diffusion of Innovation • Dr. Everett Rogers • Five attributes of innovation • Relative advantage • Compatibility • Complexity • Trialablity • Observability (Robinson, 2009)
Case Study Increased risks for patient complications and errors (Institute of Medicine, 2011)
Root Cause Analysis ? ? Increased Risks for Complications and Errors ? ? (Mind Tools, 2012)
Root Cause Analysis Working Relationship Staffing Increased Risk for Complications and Errors Education/ Experience Care Environment
BSN IN TEN • Life Long Learning • American Nurses Association & American Association of Colleges of Nursing Support BSN • SEIU rejects any bill mandating a BSN as entry level • Some states are seeking legislation supporting the BSN (Smith, 2009) (SEIU)
ANA Standards/QSEN • Teamwork & Collaboration • Nurses will demonstrate attitudes reflecting they feel equally educated to effectively contribute in collaboration with others health care members by receiving higher education (ANA, 2004) (QSEN, 2012)
Quality Improvements • Quality Improvements / Quality of Practice • Nurses will have obtained the skills needed to provide improved quality of care using aims, measures and changes to reach their goals. (ANA, 2004) (QSEN, 2012)
Safety & Resource Utilization • Safety/Resource Utilization • Entry level nurses will demonstrate effective us in technology and standardized practices that support safety and lead to improved patient outcomes. (ANA, 2004) (QSEN, 2012)
Conclusion
References • American Association of Colleges of Nursing. (2012). The impact of education in nursing practice. Retrieved from https://fsuvista.ferris.edu/webct/urw/lc4779355726061.tp4844248911011/RelativeResourceManager/sfsid/5226378117051 • American Association of Colleges of Nursing. (2000). The baccalaureate degree in nursing as minimal preparation of professional practice. Retrieved from http://www.aacn.nche.edu/publications/position/bacc-degree-prep • Current Nursing, (2012). Application of theory in nursing process. Retrieved on September 21, 2012 from http://currentnursing.com/nursing_theory/application_nursing_theories.html • Current Nursing. (2011). From novice to expert: Patricia Benner. Retrieved from http://currentnursing.com/nursing_theory/Patricia_Benner_From_Novice_to_Expert.html • DeBasoi, N. & Fetsch, S. (2011). Educational advancements of Registered Nurses BSN in ten. Retrieved from http://www.mlnmonursing.org/Content/CMSUploads/White%20paper.pdf • Egenes, K. J. (n.d.). History of nursing. Retrieved from http://www.jblearning.com/samples/0763752258/52258_CH01_Roux.pdf
Hawkins, P. (2000). Entry level competence of nurses by type of program. Retrieved rom http://www.csm.edu/wfdata/files/Academics/Library/InstitutionalRepository/9.pdf • Institute of Medicine, (2011). The future of nursing: Focus on education. Retrieved from http://www.iom.edu/Reports/2010/The-Future-of-Nursing-Leading-Change-Advancing-Health.aspx • Mind Tools. (2012). Root cause analysis; Tracing a problem to its origins. Retrieved from http://www.mindtools.com/pages/article/newTMC_80.htm • Robinson, L. (2009). A summary of Diffusion of Innovations. Retrieved from http://www.enablingchange.com.au/Summary_Diffusion_Theory.pdf • SEIU. (n.d.) SEIU Healthcare; Position statement on BSN requirement for RN practice. Retrieved fromhttp://www.seiu.org/a/healthcare/position-statement-on-bsn-requirement-for-rn-practice.php • Smith, T., (2010). A policy perspective on the entry into practice issue. The Online Journal of Issues in Nursing, 15(1). DOI: 10.3912/OJIN.Vol15No01PPT01 • White, L. (2001). The foundations of nursing; Care for the whole person. Albany, NY: Delmar
