Degree-prepared Nurses Research Articles

Labor Market Participation of Bachelor's Degree Prepared Nurses in Mexico: Lessons for Capacity Building.

Mexico has learned much from its five decades educating nurses, moving from nurses educated mostly at the technical degree level, to bachelor's degree prepared nurses educated in universities. Several salient lessons have emerged that may prove relevant for other countries seeking to increase their numbers of bachelors prepared nurses. This paper analyzes twenty years of nursing labor market data to highlight where significant social and policy changes helped facilitate increased production of bachelor's degree educated nurses in Mexico. We conducted a two-stages analysis, starting with a descriptive stage and followed by a repeated cross-sectional analysis using data sources generated by the Secretariat of Health and the National Institute of Geography and Statistics. Data from the 2005 to 2019 period were analyzed for trends in production patterns and significant relationships in the labor market. Among Mexican nursing graduates, technical and bachelor nurses compete for employment in healthcare institutions. The public sector has greater success in hiring bachelors prepared nurses, but this varies by type of public sector institution. Technical degree nurses have higher underemployment rates and less job security overall. Private hospitals mainly hire technical degree nurses. The Mexican government not been able to properly regulate neither the production of new graduates nor the accreditation of schools, let alone to align roles according to the graduate's level of education. The success of Mexico in the twenty-first century shows that middle-income countries can increase the production and both private and public sector employment opportunities for nurses educated at both the technical and bachelor's degree level however, labor market challenges persist. The central lesson for other countries is that policies must be revised in order to optimize the use of a more educated nursing workforce.

Development of an educational program using ultrasonography in vascular access for nurse practitioner students.

Ultrasonography is an important tool for vascular access practice. Ultrasound should be used for vascular access assessment and insertion. Ultrasonography should be incorporated into formal nursing education curriculum and simulation training. This study analyzed nurse practitioner students' knowledge of ultrasound-guided vascular access after the implementation of an educational and simulation course. Nurses' knowledge of ultrasound-guided peripheral intravenous catheter placement was analyzed using a ten-item questionnaire both before and after course. A sample of bachelor's degree-prepared nurses voluntarily participated in this study. Ultrasonography simulation was carried out with two handheld ultrasound devices and two ultrasound blocks. The findings demonstrated that there is a statistically significant increased comprehension of ultrasoundguided vascular access after simulation courses. This study illuminates the need for formal education both in academic curriculum and through simulation to improve ultrasound-guided vascular access knowledge for patient care.

Labor Market Participation of Bachelor's Degree Prepared Nurses in Mexico: Lessons for Capacity Building

Labor Market Participation of Bachelor's Degree Prepared Nurses in Mexico: Lessons for Capacity Building

Developing a Virtual Nursing Team to Support Predictive Analytics and Gaps in Patient Care.

Development and implementation of a predictive analytic scoring system in a system of 21 hospitals required 24-hour surveillance to ensure alerts were responded and acted upon. Identification of gaps in patient care created an opportunity to innovate and develop a team to integrate both workflows. A Virtual Nurse team of master's degree-prepared nurses with backgrounds in intensive care and management led by a clinical nurse specialist work remotely from their homes. Each nurse is assigned to either of 2 workflows: Advance Alert Monitor-predictive analytic scores or e-Hospital involving capturing of care gaps. The Virtual Nurse team covers 24 hours a day/7 days a week. The program has resulted in 169 lives saved and an observed-to-expected mortality of 0.8. Improvements in standard workflows across the system have enabled Rapid Response Teams to be implemented in each hospital. The success of the Virtual Nurse team has resulted in developments to spread the program into other Kaiser Permanente regions. The Virtual Nurse team has grown to 40 nurses and will expand as the program spreads.

Building a Practice-Focused Academic-Practice Partnership.

A practice-focused academic-practice partnership merging the strengths and resources of 2 faith-based community organizations built evidence-based practice, nursing research, and innovative nursing programs. The unique partnership emphasizing quality care and patient outcomes resulted in hospital-acquired infection reduction, interventional research reducing readmissions, clinical redesign, increased percentage of bachelor's degree-prepared nurses, and dissemination through publication and presentation. Key elements to partnership success were shared mission and vision, program oversight, strong contract, and annual plans with specific measurable outcomes.

Using Motivational Interviewing to Impact Readiness of RNs to Return to the Classroom.

Supporting nurses with associate degrees in nursing (ADNs) to return to school is challenging for nurse executives. Strategies include tuition reimbursement, scholarships, and flexible scheduling. Despite these measures, it is anticipated that we will fall short of a goal of 80% bachelor's degree-prepared nurses by 2020. The aim of this project was to increase ADN-prepared RN readiness to return to school through motivational interviewing.

Top-of-License Nursing Practice, Part 2: Differentiating BSN and ADN Perceptions of Top-of-License Activities.

The aim of this study was to describe differences in associate degree (ADN) and baccalaureate degree-prepared (BSN) nurses' perceptions of top-of-license (TOL) practice. To date, no empirical work has examined whether ADN and BSN nurses approach TOL practice nursing activities differently. We conducted a qualitative pilot study with focus groups to explore the perceptions of a group of ADN- and BSN-prepared nurses concerning nursing activities and their relation to TOL practice. Subthemes emerged differentiating how ADN and BSN nurses perceived their responsibilities related to critical thinking, communication, and patient education. For professional nursing care, 5 subthemes further emerged: (a) approaches to assessment, (b) chart review, (c) psychosocial patient care, (d) documentation, and (e) handoff. The differences identified in approaches to TOL practice activities by educational preparation have implications for staffing patterns that can optimize the contribution of ADN- and BSN-prepared nurses. Further research is indicated.

From Innovative Idea to State-Supported Policy: Academic Progression in Prelicensure Registered Nurse Education Using the Partnership Model

Changes in the registered nurse (RN) employment market in 2012 and 2013 negatively affected both employment for RNs and associate degree-prepared nurses (ADNs) and clinical placement for students in ADN preparation programs. To address this challenge, ADN nursing programs partnered with a university to create an innovative alternative to traditional prelicensure RN nursing education by sharing curricula among them. With the program, students simultaneously complete the ADN nursing degree onsite at the community college and the bachelor of science degree in nursing (BSN) online, with both degrees conferred at the end of the respective nursing programs, in time for the graduate to sit for the National Council Licensure Examination-Registered Nurse (NCLEX-RN) and enter the workforce as a BSN-prepared nurse. This example of seamless academic progression is known in Kansas as the Partnership Model.

Scholarship in nursing: Degree-prepared nurses versus diploma-prepared nurses

Background: The nursing profession needs nurses with a higher level of education and not merely more nurses to enhance patient outcomes. To improve quality patient care the nursing discipline needs to be advanced through theory development and knowledge generation, thus graduate nurses. Nursing scholarship cannot be limited to nurse academics, but is the responsibility of every nurse. Although the world is looking towards combating the decline in nursing numbers with better educated nurses, South Africa is planning to address the problem with more lower qualified nurses.Aim: The aim of this study being reported here was to establish whether degree-prepared nurses in South-Africa partake more often in scholarly activities than diploma-prepared nurses.Method: A cross-sectional descriptive design was used. The population was all professional nurses registered with the South African Nursing Council who obtained either a four year degree or four year diploma in nursing. Data were gathered from 479 respondents, using aself-administrative questionnaire.Results: Three times more nursing educators (n = 19) achieved a degree as first qualification than their colleagues (n = 6) who achieved a diploma as first qualification. All but one (n = 18) nursing educators who obtained a degree as first qualification are educators in the private sector that include both universities as well as nursing colleges of private hospital groups. Data further revealed that most nurse educators and those in managerial positions were degree prepared. More degree prepared nurses than diploma prepared nurses were actively involved in scholarly activities such as research (30,5% compared to 25,5%) andimplementing best practice guidelines (62,2% compared to 55,9%).Conclusion: The global nursing crisis, nor the nursing profession, will benefit by only training more nurses. The profession and the health care sector need more degree prepared nurses to improve scholarship in nursing.

Scholarship in nursing: Degree-prepared nurses versus diploma-prepared nurses

BackgroundThe nursing profession needs nurses with a higher level of education and not merely more nurses to enhance patient outcomes. To improve quality patient care the nursing discipline needs to be advanced through theory development and knowledge generation, thus graduate nurses. Nursing scholarship cannot be limited to nurse academics, but is the responsibility of every nurse.Although the world is looking towards combating the decline in nursing numbers with better educated nurses, South Africa is planning to address the problem with more lower qualified nurses. AimThe aim of this study being reported here was to establish whether degree-prepared nurses in South-Africa partake more often in scholarly activities than diploma-prepared nurses. MethodA cross-sectional descriptive design was used. The population was all professional nurses registered with the South African Nursing Council who obtained either a four year degree or four year diploma in nursing. Data were gathered from 479 respondents, using a self-administrative questionnaire. ResultsThree times more nursing educators (n = 19) achieved a degree as first qualification than their colleagues (n = 6) who achieved a diploma as first qualification. All but one (n = 18) nursing educators who obtained a degree as first qualification are educators in the private sector that include both universities as well as nursing colleges of private hospital groups.Data further revealed that most nurse educators and those in managerial positions were degree prepared. More degree prepared nurses than diploma prepared nurses were actively involved in scholarly activities such as research (30,5% compared to 25,5%) and implementing best practice guidelines (62,2% compared to 55,9%). ConclusionThe global nursing crisis, nor the nursing profession, will benefit by only training more nurses. The profession and the health care sector need more degree prepared nurses to improve scholarship in nursing.

Statistical Preparedness of Master's Degree-Prepared Nurses in the Workplace.

Knowledge of statistics is essential for nurses at all degree levels and is needed to read and understand published research, make evidence-based decisions, and critically evaluate research and evaluation findings. Data are needed to properly quantify statistical preparedness for nurse graduates and workplace demands for specific types of statistics knowledge. This work describes results of a pilot study of surveyed master's degree-prepared nurses. Findings revealed several gaps between statistics education and workplace demands.

Experiential learning: using virtual simulation in an online RN-to-BSN program.

This article highlights the innovative experiential learning used by an online RN-to-BSN program through the use of simulation that takes place in an online classroom. Three experiential learning activities using a virtual community are described. These learning activities engage the students in thinking about social justice and health policy, as well as teaching concepts that include community, leadership, influence, advocacy, networking, collaboration, and vulnerable populations. These concepts are critical to the learning needs of diploma and associate degree-prepared nurses who wish to continue their education to be better prepared to meet the complex needs of today's health care environment.

Reeling in RNs with a residency program.

Reeling in RNs with a residency program.

Evaluating the predictive validity of preadmission academic criteria: High-stakes assessment

The purpose of this article is to identify preadmission predictor's variables of National Council Licensure Examination for Registered Nurses (NCLEX-RN) first attempt outcome in associate degree-prepared nurses. As variations in admission criteria exist nationwide, establishing a reliable profile of preadmission requirements is necessary. Through regression analysis, repeated attempts in preadmission science courses were found to be a significant predictor of NCLEX-RN outcome. Continuing to recruit interested students paying close attention to the number of attempts at a science course is recommended.

Rural nurses’ continuing education needs: A U.S. multi-site survey reveals challenges and opportunities

Background: Provision of relevant, evidence-based continuing education (CE) is an integral part of maintaining a highly competent rural nursing workforce. Numerous tangible and intangible barriers exist to nurses’ participation in CE in rural settings. Major barriers to accessibility and participation in CE for rural nurses include: 1) Geographic isolation, 2) lack of perceived administrative, financial, and/or technological resources and support, 3) lack of time due to workload, inadequate staffing, and/or travel distance, 4) lack of relevance of continuing education topics, and 5) lack of a dedicated on-site nurse educator. Proactive development of academic-practice partnerships is important to support rural care providers regarding CE delivery. The purpose of this study was to assess perceptions of CE needs of nursing unit staff working in a group of health care facilities in a rural region of midwestern U.S. Methods: A cross-sectional CE needs assessment survey was conducted in winter of 2010 with rural health care providers (N=302/1107; response rate 27%) working in rural healthcare facilities (N=40), including rural hospitals (n=10) and long-term care (LTC) facilities (n=30). A well-validated 72-item Likert-type survey was distributed via a secure online university survey platform, and included assessment of 59 CE need areas. Internal consistency reliability was 0.87. Data were analyzed using SPSS software, version 16.0. Results: Descriptive statistics revealed a greater number of licensed practical nurses and nursing assistants working in rural LTC’s (27.2% and 62.5%, respectively) compared to rural hospital setting (14% and 15%, respectively). There are a large number of associate degree-prepared nurses (63%) working in the participating rural hospitals compared to LTC setting (8.4%). Respondents’ priority learning needs included: 1) Review aspects of medication administration/drug interactions; 2) improve skills in patient assessment (physical/mental); 3) increase knowledge of management of patients with comorbidities; 4) promotion of patient safety; 5) enhance communication skills/teamwork; 6) increase lifelong learning. Student’s t tests revealed LTC nursing unit staff reported significantly higher priority learning needs in “manage aggressive behavior (verbal/physical)” ( t = 2.044, d f = 300, α = .003), “family participation in care” ( t = 2.470, d f = 300, α = .036), and “maintain standards of care” ( t = 2.880, d f = 300, α = .042), whilst acute care nursing staff reported a significantly higher priority learning need in “manage a crisis” ( t = 2.122, d f = 300, α = .050). Conclusions: Study results revealed key learning needs related to several aspects of patient care delivery for rural nursing unit staff who are primarily nursing assistants or nurses meeting minimum state educational requirements. Basic health- care workforce training does not typically emphasize continuous quality improvements, or how to recognize and develop an evidence-based practice at the entry level. The potential for nursing knowledge stagnation among entry level nursing unit staff in rural settings needs to be addressed to help break down isolation barriers impacting knowledge, attitudes and behaviors of health care providers practicing in rural health care facilities.

Future of nursing: Institute of Medicine report

Future of nursing: Institute of Medicine report

Associate degree nursing: entry into practice—link to the future

Associate degree nursing is in a unique position to address two challenges currently facing the nursing profession—the shortage of registered nurses and the lack of adequate numbers of baccalaureate degree-prepared nurses. Associate degree nursing programs increase the numbers of adequately prepared nursing graduates through enrollment increases and retention measures while encouraging and assisting associate degree-prepared nurses to obtain their baccalaureate degrees in nursing. Improved patient outcomes can be attained through each of these initiatives.

Frequency of Postlicensure Registered Nurse Boundary Violations with Patients in the State of Ohio: A Comparison Based on Type of Prelicensure Registered Nurse Education

Nurse-Patient boundary violations remain a problem. Efforts to address the problem through postlicensure education and stronger disciplinary measures are well documented. However, efforts to understand this problem based on prelicensure components are less studied. Using data from The Ohio Board of Nursing from 2002 to 2006, the difference in frequency of incidents of violations between associate degree-prepared registered nurses and baccalaureate degree-prepared registered nurses was studied. A statistically significant difference was found through chi-square analysis: Associate degree-prepared nurses had higher frequency of boundary violations. Further studies on prelicensure curricular influences on registered nurses' postlicensure behavior, particularly in relation to curricular content focused on interpersonal skill development, are recommended.