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What every nurse needs to know

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Page 1: What every nurse needs to know

What Every Nurse Needs to Know 

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Page 2: What every nurse needs to know

0%

20%

40%

60%

80%

100%

Before 1960 1960s 1970s 1980s 1990s 2000s

Diploma Associate's Bachelor's/Master's

Trends in Nursing Education

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Page 3: What every nurse needs to know

Each year, out of 100 RNs seekingNYS licensure, 62 are Associate and

38 are Baccalaureate Graduates

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Page 4: What every nurse needs to know

Graduates from basic nurse baccalaureate programs are over

3 times more likely to obtain graduate degrees

Initial BSN Graduates

Initial ADN Graduates

Adapted from: Aiken, Cheung, Olds. 2009. Health Affairs 28(4)Brought to you by

Page 5: What every nurse needs to know

RESEARCH FINDINGS

Multiple Researchers have demonstrated a significant relationship

between nursing education and improved patient outcomes

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Page 6: What every nurse needs to know

65

70

75

80

85

90

95

20% 40% 60%

As Nurse Education Increases, As Nurse Education Increases, Patient Patient MortalityMortality Decreases. Decreases.

Dea

ths p

er 1

000

patie

nts w

ith c

ompl

icat

ions

Education (Percentage of hospital nurses with BS degrees.) 232,342 patients from 168 PA non-federal adult general hospitals.

Aiken, 2003, JAMA

90 deaths

in 1,000

patients84

deaths in

1,000 patients

76 deaths

in 1,000

patients

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Page 7: What every nurse needs to know

NYS Thirty Day Surgical Mortality Preventable with each 10% Increase in

BS Prepared Nurses

0

5,000

10,000

15,000

20,000

25,000

30,000

35,000

TotalDeaths

5% 10% 15% 20%

DeathsPrevented Deaths

NYS

30

day

mor

talit

y su

rgic

al d

isch

arge

s

Percentage of Decreased Deaths with each 10% increase in BS Prepared Nurses

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Page 8: What every nurse needs to know

Hospitals with a higher proportion of BSN RNs experienced lower rates of 30-day patient mortality

Replication of Aiken study in 18,142 patients in 49 hospitals in Alberta, Canada

with identical results

Estabrooks, et al. (2005)

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Page 9: What every nurse needs to know

• Study of 46, 993 patients• Demonstrated 9 fewer deaths per

1,000 discharges for every 10% increase in BS prepared nurses

Tourangeau (2007)

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Page 10: What every nurse needs to know

• Longitudinal study of 21 US hospitals over 84 quarters

• In hospitals with a higher proportion of BS educated nurses:– Lower rates of CHF mortality– Fewer Hospital Acquired Pressure Ulcers– Lower Rates of Failure to Rescue– Shorter Hospitalizations

Blegen & Goode (2009)

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Page 11: What every nurse needs to know

Changes in the Health Care Environment

*Advances in science *Increasingly diverse population *Care over continuum - medical homes *Value Based Purchasing – paying for outcomes

These factors have resulted in increased patient complexity, accelerating the need for nurses with broader skills and knowledge to

manage & coordinate care of more diverse and challenging populations across all settings.

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Page 12: What every nurse needs to know

Philippines:BSN RequiredSince 1988

Australia:BSN RequiredSince 1992

Canada:New RNs must be BS prepared European

Union:BS required

Transformation of Nursing Education

Thailand: BS required

Turkey:BSN requiredsince 1997

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Page 13: What every nurse needs to know

RN Athletic Training

Diploma/Associate

BS Master’s Doctorate

Midwifery

Nurse Practitioner

Occupational Therapy

Speech Lang. Path.

Audiology

Lic. Clin. Soc. W.

Lic. Masters Soc. W.

Lic. Mental Hlth Couns.

Physical Therapist

Medicine

Dentistry

Podiatry

Psychology

Pharmacy

Minimum Entry-Level Education Requirements for

Select Licensed Health Professions

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Page 14: What every nurse needs to know

2010 Carnegie Foundation reportEducating Nurses: A Call for

Radical Transformation (Patricia Benner, et al.) calls for

the BS degree in nursing for licensure

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Page 15: What every nurse needs to know

2008-RWJF-IOM Collaboration

Chaired by former

Department of Health and Human Services Secretary Donna Shalala

2010- Release of the Report

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Page 16: What every nurse needs to know

October 2010 Report Recommends that 80% of RNs be prepared with the BS degree by

2020.

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Page 17: What every nurse needs to know

Question 4.

The “BS in 10” proposal would close associate degree programs because every RN would need to obtain a BS degree after the bill is passed into law.

1.True2.False

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Page 18: What every nurse needs to know

Question 5.

The “BS in 10” proposal would require every currently licensed RN to obtain a BS degree within 10 years after the bill is passed into law.

1.True2.False

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Page 19: What every nurse needs to know

PROPOSALWould permit persons with a diploma or

associate degree in nursing,seeking future licensure, to obtain that

licensure but,would require such applicants to obtain a BS

degree in nursing 10 years after that initial licensure.

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Page 20: What every nurse needs to know

PROPOSAL

    

   

Opportunity for an extension beyond 10 years, for extenuating circumstances, as determined by the Department.

Grand parenting of all currently licensed (RNs);

Time to permit all students on a waiting list or enrolled in associate or diploma programs to complete their studies and be grand parented

Provisions that would place a Registered Nurse’s license on “hold” if the baccalaureate degree is not obtained in 10 years.

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Page 21: What every nurse needs to know

Current Status of the Board’s Motion

Assembly Bill # ?? Sponsor?? Senate Bill # ?? Sponsor??

NYONE takes Lead in Seeking Legislative Support

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Page 22: What every nurse needs to know

*Project 6,000 fewer surgical deaths annually when 60% of nurses are prepared at the BS level.

*Project a 10% reduction in the 200,000 hospital acquired pressure ulcers each year. The published additional length of stay from hospital acquired pressure ulcers is 3.98 days, thus the potential savings is 17.5 million dollars annually.

*With the reduction of the Length of Stay (LOS) by 0.2 days there is a potential capacity for 400,000 additional patient days.

*Every 1% reduction in RN turnover saves $12.9 million statewide.

Benefits to New York

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Page 23: What every nurse needs to know

The Plight of New Graduates

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Page 24: What every nurse needs to know

Many hospitals are responding to research and Magnet expectations by requiring their nursing staff to

hold the BS in Nursing degree.

Page 25: What every nurse needs to know

Perceived Problems/Concerns

STATEMENT RESPONSEIf I get my BS I will be removed from bedside nursing.

I’m content at what I’m doing why should I go on to the BS degree?

I’m just as good as any BS prepared nurse!

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Page 26: What every nurse needs to know

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