what every nurse needs to know
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What every nurse needs to knowTRANSCRIPT
What Every Nurse Needs to Know
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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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Each year, out of 100 RNs seekingNYS licensure, 62 are Associate and
38 are Baccalaureate Graduates
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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
RESEARCH FINDINGS
Multiple Researchers have demonstrated a significant relationship
between nursing education and improved patient outcomes
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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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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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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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• 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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• 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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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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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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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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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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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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October 2010 Report Recommends that 80% of RNs be prepared with the BS degree by
2020.
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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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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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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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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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Current Status of the Board’s Motion
Assembly Bill # ?? Sponsor?? Senate Bill # ?? Sponsor??
NYONE takes Lead in Seeking Legislative Support
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*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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The Plight of New Graduates
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Many hospitals are responding to research and Magnet expectations by requiring their nursing staff to
hold the BS in Nursing degree.
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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