...create a more highly qualified nursing workforce since education enhances both clinical competency and care delivery. This fact sheet looks at today’s nursing workforce; highlights research connecting education to outcomes; and outlines the capacity of four-year colleges to enhance the level of nursing education in the U.S. Snapshot of Today’s Nursing Workforce According to the National Center for Health Workforce Analysis within the Health Resources and Services Administration (HRSA), approximately 2.8 million registered nurses (RNs) are currently working in nursing (HRSA, 2013). This count reflects an increase from the last National Sample Survey of Registered Nurses conducted by HRSA in 2008 which found that 2.6 million RNs were employed in nursing (out of a population of more than 3 million licensed RNs). HRSA’s 2013 report, titled The U.S. Nursing Workforce: Trends in Supply and Education, also found that 55% of the RN workforce held a baccalaureate or higher degree. In a separate study conducted by the National Council of State Boards of Nursing and The Forum of State Nursing Workforce Centers in 2013, the percentage of nurses in the U.S. with a baccalaureate or higher degree was 61%. Graduates of entry-level nursing programs (baccalaureate degree, associate degree and diploma) sit for the NCLEX-RN© licensing examination. The fact that new nurses pass the licensing exam at the same...
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...* kforce. Canada, Sweden, Portugal, Brazil, Iceland, Korea, Greece and the Philippines are just some of the countries that require a four-year undergraduate degree to practice as a registered nurse. Fact Sheet References 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. Aiken, L.H., Clarke, S.P., Cheung, R.B., Sloane, D.M., & Silber, J.H. (2003, September 24). Educational levels of hospital nurses and surgical patient mortality, Journal of the American Medical Association, 290, 1617-1623. American Association of Colleges of Nursing (2012). 2011-2012 Enrollment and graduations in baccalaureate and graduate programs in nursing. Washington, DC: Author. American Association of Colleges of Nursing, American Organization of Nurse Executives, & National Association of Associate Degree Nursing (1995). A model for differentiated practice. Washington, DC: American Association of Colleges of Nursing. Available online at www.aacn.nche.edu/aacnpublications/position/joint-statement-academic-progression. American Association of Colleges of Nursing, American Organization of Nurse Executives, & National Association of Associate Degree Nursing (1995). A model for differentiated practice. Washington, DC: American Association of Colleges of Nursing. American Organization of Nurse Executives. (2005). Practice and education...
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...housing prices may be associated with the differing perceptions of risk by experts and lay persons. Looking specifically at housing prices and nuclear material, this paper uses several studies that failed to establish a link between property values in the vicinity and nuclear power plants that were in close proximity to the houses. This is presumably due to the positive economic affect associated with the plant, such as increased tax base and high paying jobs. However, the authors study nuclear waste storage and transport, an area that may show a negative relationship because there are no offsetting economic benefits, such as well-paying jobs or larger tax revenues. The study focuses on shipments through three counties in South Carolina: Aiken, Beasley and Charleston. Shipments consisted of highly radioactive spent fuel rods, which were previously loaned to foreign governments under the condition that the rods be returned to the U.S. once they were spent (to prevent use of the rods in nuclear weapons)....
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...Safe Staffing Examine Nurse-to-Patient Ratios Primary health care organizations such as New York Presbyterian (NYP) are impacted by low nurse-to-patient ratios. The recent implementation of the Patient Protection and Affordable Care Act (ACA) has required organizations such as NYP to explore many approaches to improve quality and patient outcomes that contain costs. “Numerous studies reveal an association between higher levels of experienced RN staffing and lower rates of adverse patient outcomes” (www.nursingworld.org, 2015, para. 1). For this reason, nurse-to-patient ratios is an issue that needs to be addressed at NYP in order to improve quality healthcare within their organization. The acuity of the unit in which patient care is being provided, should determine the acceptable nurse-to-patient ratio. According to the American Nurses Association (ANA), factors that influence the nurse staffing needs include: patient complexity, acuity, or stability; number of admissions, discharges, and transfers; professional nursing and other staff skill level and expertise; physical space and layout of the nursing unit; availability of or proximity to technological support or other resources ("Optimal Nurse Staffing," 2015). Currently, New York is one of only fourteen states that addresses the nurse staffing issue in hospitals. New York State requires organizations such as NYP to disclose their nurse-to-patient staffing ratios to the public; however the state does not require a minimum...
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...There are varied avenues of academic development that prospective nursing students can select from when contemplating entering into the field. The two most frequently achieved pathways in nursing education for an entrance position, is an associate’s degree or a bachelor’s degree in nursing. A survey organized by the Health Resources and Services Administration in 2008, demonstrated that fifty percent of nurses retained a bachelors degree or higher and that at least thirty-six percent received an associate’s degree ("Fact sheet: Creating," 2012). However, the variance between the degree levels statistically is not the only differentiating consideration. The primary disparities among an associates and bachelors degree in nursing are curriculum based, patient outcome related, administrative preparation and opportunity. Presently, either approach to nursing study is an acceptable path to establish a career in the discipline; however the education levels differ considerably in these particular areas of concentration. An associate degree program in nursing serves to instruct pupils on fundamental nursing skills, in comparison, a bachelor degree is focused on progressive courses of research and nursing principles. The associate level is two years in length and based regularly at community colleges; as a result graduates are able to execute a transition to the workforce more promptly. A prerequisite of general studies is required to obtain acceptance to a nursing program at this...
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...level. Graduates from all three pathways take the same NCLEX-RN exam. The NCLEX-RN exam is multiple choice and tests the minimum competency for practicing nursing safely. Once an individual passes the exam they are licensed to practice. Currently the exam is focused on acute care setting. As the health system sways from the acute care scene to the primary care environment the focus of the exam will need to change to meet these demands. The exam will need to emphasis on community health, health promotion and primary care. As our health system transform, there comes a demand to have a nurse with a higher education. Studies have shown better patient outcomes when there is a BSN prepared nurse at the bedside (Aiken, Clarke, Sloane, Lake, & Cheney, 2003;Kutney-Lee, Sloan, & Aiken, 2013) . The baccalaureate prepared nurse who is trained, unlike the associates prepared nurse, will be needed to make clinical decisions independently, case manage and educate patients on the importance of compliance with treatment regimens and preservation of good health. The National Advisory Council on Nurse Education and Practice (NACNEP) report the baccalaureate prepared nurse is the best...
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...excessive workloads contribute to burnout and dissatisfaction leading to nurse attrition that further compounds to the staffing problem. Hospitals need to be held accountable for providing safer nurse staffing levels. Payers and purchasers of care should demand compliance, but should also stimulate better quality and patient safety by providing financial incentives. In addition, a more comprehensive, proactive team approach to nurse staffing can help keep patients safer and help hospitals better manage staffing expenditures. Nurse Staffing and Adverse Events Increasingly, studies continue to show links in patient deaths and adverse events to inadequate nurse staffing levels in acute care hospitals (Needleman, et. al., 2002; Aiken et. al., 2002; Needleman, et.al, 2011). In terms of adverse events, higher levels of nurse staffing, measured in...
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...Baccalaureate prepared nurses versus Associate prepared nurses Shirley Jones Baccalaureate prepared nurses versus Associate prepared nurses What are the differences between baccalaureates prepared nurses and associates prepared nurses? This has been a topic for discussion for many years. Prior to the modern practice of nursing, the sick were taken care of by the less-than-desirable population such as “sinners, saints or mothers”. (L. Hover, lecture notes, June 2013). Times have changed since the days when prostitutes and women of ill repute or members of religious orders tended to the sick. (L. Hover, lecture notes, June 2013). In today’s nursing, no major differences are noted between the cognitive abilities of students in baccalaureate and associate degree programs (Davis-Martin, 1990). Baccalaureate nurses are generally seen as being better prepared for a wide range of nursing competencies and are seen as performing in the professional role in which they are prepared. Associate degree nurses are seen as performing well in the technical role for which they have been prepared, as well as in some leadership roles for which they were not originally prepared (Davis-Martin, 1990). One difference in competencies between the Associate Degree Nurse (ADN) and the Baccalaureate Degree Nurse (BSN) is the time spent in the formal education process. The associate prepared nurse usually obtains their degree from a community college or junior college whereas the BSN...
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...Did you know that 60 percent of all nurses are graduates from an associate’s degree program? (Aiken, 2011) The Institute of Medicine (IOM) was founded in 1970 to help the government and non-government establishments make decisions in health care by evidence base practices. In 2010 The Institute of Medicine, sponsored by the Robert Wood Johnson Foundation and AARP, conducted a study on the future of nursing. The study was involved and asked the questions of “who,” “what,” “where,” “when,” “why,” and “how” of nursing to produce better quality patient care. The IOM instituted initiatives or a project plan to reform nursing care. Lets touch base on how the IOM initiatives made in impact on nursing education, nursing care, and nursing leadership roles. Education Education is a very important part of a nursing career, with advancing technology, the nurse has to stay informed and up to date. Education can be acquired by certifications and advancing in higher education. The IOM initiative has increased the awareness of the need of higher educated nurses. Nursing is broad and is advancing to public health care, preventative care, and chronic care, not just acute care. (Aiken, 2011) The IOM initiative drives the education system to help nurses pursue higher education without difficulties, like in the past. There is more programs designed to help the nurse work and go to school at the same time. The initiative implemented the idea for more funding for applicants, as well as, for the...
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...ACUTE RENAL FAILURE Overview Acute renal failure is the most common disease in the acute care setting. It is estimated that acute renal failure occurs in up to 25% of all patients admitted to the hospital with a critical illness (Broden, 2009). It is even noted that patients who are admitted to the intensive care unit with no prior renal insufficiencies seem to have worse outcomes than do patients who have preexisting acute renal failure (Broden, 2009). Acute renal failure is a rapid decrease in kidney function, leading to collection of metabolic waste in the body. The pathophysiology of acute renal failure is reduced blood flow to the kidneys, toxins, infections and obstruction (Broden, 2009). There are three types of acute renal failure. They are pre-renal azotemia. This is caused by poor blood flow to the kidneys. The most common causes of this are hypovolemic shock and heart failure. The second type is intra-renal acute renal failure. This is caused by infections, drugs, tumors, glomerulonephritis, and obstruction. The third type is post-renal azotemia. It is caused by an obstruction outside of the kidneys (Dirkes, 2011). Assessment Data Ongoing comprehensive assessments are critical for the acute renal failure patient. The nurse must be attentive to the signs and symptoms of renal disease as well as complications with other organs and systems. The primary effect of acute renal failure is a decrease in urinary output that leads to fluid retention and edema. Oliguria...
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...Impact and Future of Nursing in Reference to the IOM Report In Transforming Nursing Education, Primary Care, and Leadership Grand Canyon University: NRS-430V October 23, 2015 Impact and Future of Nursing in Reference to the IOM Report in Transforming Nursing Education, Primary Care, and Leadership Nursing’s future is greatly impacted by the need for major transformation as recommended by the Institute Of Medicine report (IOM, 2010). Nursing must act fast and come forward as leaders to make changes in their practice. Demand for highly educated nurses and the growing healthcare customer needs are the focus point of IOM report. This paper shows the impact of the IOM report on nursing education, primary care, and nurse leadership. Changes that could be made to the daily practice of nursing to meet the goals, as well as some of the writer’s thoughts, are also explained. If the IOM report (2010) recommendations are not followed, the future of nursing could be negatively impacted because nurses have to be well educated and adequately prepared to practice nursing to their full magnitude of training; more advanced practice nurses (APRN) are needed to meet the growing healthcare needs of society, and nurses need to be involved in decision making affecting the health of future population. For the future of nursing, current nursing education needs to be transformed. Compared to other healthcare professions nursing is undereducated starting with one year practical...
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...Running head: DIFFERENCES IN COMPETENCIES ADN VS BSN The Differences in Competencies between Nurses Prepared at the Associate Degree Level vs. the Baccalaureate Degree Level. A competent nurse has the knowledge and skills needed to perform well in her work environment. There has been much discussion over how the level of competency is affected by a nurse’s educational preparation. Before the influence of Florence Nightingale there was no formal education for nurses and their work and social status was considered very low. Now partly because of the work of our nursing pioneers nurses are respected and educated professionals. In the United States there are currently three recognized routes to becoming a Registered Nurse. There are Diploma Schools which are hospital based and rely on the apprentice model, the Associate Degree, started by Mildred Montag in response to a post World War II nursing shortage and the Baccalaureate degree. According to the American Association of Colleges of Nursing, Fact Sheet: Creating a More Highly Qualified Nursing Workforce:” The fact that new nurses pass the licensing exam at the same rate does not mean that all entry-level nurses are equally prepared for practice. The NCLEX tests for minimum technical competency for safe entry into basic nursing practice.” The test does not differentiate between the ADN and BSN educational backgrounds. The ADN graduates from a two year program most often in a Community College...
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...Competencies of Baccalaureate-Degree Nurses As health care becomes more complex and clinical knowledge expands, nurses must have the appropriate educational groundwork to competently perform their job. As the delivery of care to the community becomes more complex, the old adage of a nurse simply being a bedside caregiver has evolved. More emphasis must be placed on coordinated health care, including health promotion, maintenance, and affordable managed care. In an effort to provide community-based health care outside the inpatient hospital setting, health maintenance organizations, community health, outpatient centers, home, public schools, and nursing centers were developed (American Association of Colleges of Nursing, 1998). These developments command higher educated nurses to work in environments with an advanced skill-set so as to operate independently with regards to clinical decision-making and case management. Such responsibilities encompass delegation skills in addition to organizing medical care across multiple settings. Consequently, the American Association of Colleges of Nursing (AACN) identifies “the Bachelor of Science degree in nursing as the minimum educational requirement for professional nursing practice” (AACN, 2000, para. 2). Contrary to a nurse with an associate degree, a nurse with a baccalaureate degree is outfitted to work in all health care settings. The curriculum of the BSN program incorporates “clinical, scientific, decision-making, and humanistic...
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...Problem Validation Literature Review Problem Validation Literature Review The purpose of this paper is to discuss the reviews of the literature that pertains to the problem/issue chosen by this writer. The problem/issue chosen is the current issue with staffing of hospitals, nursing homes, medical clinics and specialty clinics, and why some of those problems are occurring. In addition to current issues in staffing, the future needs of nursing staff and what is being done now, and can be done in the future to enhance the quality and quantity of practicing registered nurses. In an article published in 2004 by the Agency for Healthcare Research and Quality, it was stated that “hospitals with low nurse staffing levels tend to have higher rates of poor patient outcomes such as pneumonia, shock, cardiac arrest, and urinary tract infections. Major factors contributing to lower staffing levels include the needs of today’s higher acuity patients for more care and a nationwide gap between the number of available positions and the number of registered nurses (RN’s) qualified and willing to fill them” ( www.ahrq.gov, 2004). It is interesting that the same issues that are being faced today were an issue in 2004. “A persistent shortage of nursing staff across the United States challenges the belief and values of the profession. Many nurses find it difficult to carry out their ethical obligations to patients due to the insufficiency in staffing. Because of this shortage, many...
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...have long been a source of examination. Many studies exist relating patient outcomes and patient safety to registered nurse staffing, but there are few studies that directly compare those outcomes to the level of nursing education. In 2003 the education levels or nurses became more specified during a study in the Journal of American Medicine; prior to that all registered nurses, regardless of associates degree or bachelor’s degree were often placed into the “RN” category and LPN/LVN was the other category specifying nurses with a certificate. (Ridley, 2008) The result of this study was found that hospitals in the Unites States that employed at least ten percent more bachelor degree nurses decreased patient mortality rates by five percent.(Aiken, Clarke, Cheung, & Sliber, 2003). This study began a long controversy which exists today between associates degree nurses (ADN) and bachelors degree nurses (BSN) educated nurses with many ADN nursing programs arguing that their graduates pass the NCLEX at or above the rate of many BSN programs. In 2012 the Nevada State Board of Nursing reported that the associate’s degree school with the largest graduating class had a pass rate of 93.24% of their 74 students, whereas the largest graduating bachelor’s school graduated 96.97% of their 33 students. ("NSBN," 2012) It should be noted that the NCLEX represents the minimum competency necessary to function as a registered nurse, but a minimum competency is not enough for favorable high quality...
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