The Nursing Educational Highway in Action:Results of a Needs Assessment and the Formation of a Collaborative Workgroup

Abstract

DESPITE WIDESPREAD INTEREST IN IMPROVING THE EDUCATION OF NURSES, THE MAJORITY OF CLINICIANS CONTINUE TO BE PREPARED AT THE ASSOCIATE DEGREE (AD) LEVEL. In 2004, 1.2 million nurses with ADs accounted for 42 percent of all registered nurses in the United States, with only 21 percent returning to pursue a baccalaureate or higher degree (National League for Nursing [NLN], 2006; Health Resources and Services Administration [HRSA], 2005). Among nurses with a BSN as their initial nursing degree, only about 22 percent obtain a higher degree in nursing (HRSA). As nurse educators at a public university in the San Francisco Bay Area, we conducted a needs assessment of nurses' educational needs in partnership with administrators and practitioners at a local public hospital. The purpose was to determine barriers faced by nurses who wish to continue their formal education and to identify supports necessary to facilitate their return to school and academic success. This project led to the formation of a much larger consortium of academic and health service organizations. Assessment of Need Although applications to the university school of nursing were increasing, applications to a baccalaureate completion program were dwindling. By 2005, there were only four applicants to the RN-to-BSN program in contrast to 1200 applicants to the traditional BSN program and 400 to the master's entry program. At that time, the program received grant funding for a needs assessment from the Partnerships for Innovation in Nursing Education (PINE) program, which supports research and collaborative relationships between academic institutions and health care service providers. STAKEHOLDERS The university was able to forge a partnership with a local public hospital, one of the largest employers of nurses in the area and a provider of clinical placements for nursing students. The hospital was developing a new preceptor-training program and invited a nurse to sit on the advisory board. Hospital administrators viewed partnership as an opportunity to identify and reduce barriers to continuing formal education in their institution. The hospital nurse educator was integral to the development of the assessment tool, facilitated data collection, and assisted with data analysis. The union that represented the staff nurses at the hospital was another interested party in the partnership; union leaders viewed the issue of continuing education as a core advocacy issue. DEVELOPMENT OF NEEDS ASSESSMENT TOOL The two-part assessment tool was developed based on a review of the literature. Part 1 consisted of four yes/no knowledge questions asking participants: 1) if they were interested in continuing their education; 2) if they knew about educational programs offered at area institutions; 3) if they had knowledge of prerequisites for educational programs; and 4) if they were aware of institutional resources available to them if they decided to continue their education. Part 2 included two multiple-choice questions about personal and work barriers and supports. Four nurse union representatives reviewed the assessment tool, and minor changes were made based on their feedback. DATA COLLECTION The public hospital employed about 700 RNs (30 percent ADNs) and 250 licensed vocational nurses (LVNs) and psychiatric technicians. Nurses working in the hospital's clinics were not included in this assessment; there was no mechanism to distribute and collect information from them. A total of 630 nurses (RNs and LVNs) were eligible for participation. The union representatives on each unit gave a brief oral and written description of the needs assessment, including ethical and confidentiality issues related to participation; participation was voluntary and anonymous. Forms were distributed to nurses who heard an oral presentation, and copies of the study description and blank assessment forms were made available in the staff room. Completed assessments were deposited into secure collection boxes. …