Please respond to the discussion questions. Please also respond to the peers discussions.

DQ1

Discuss current research that links patient safety outcomes to ADN and BSN nurses. Based on some real-life experiences, do you agree or disagree with this research?

DQ2

Discuss current research that links patient safety outcomes to ADN and BSN nurses. Based on some real-life experiences, do you agree or disagree with this research?

Peer discussion 1

Due to the push for the minimum educational requirement for nurses tobe a baccalaureate degree, research has been performed to determinewhether or not nurses prepared with a baccalaureate degree actuallyperform better in practice and improve patient outcomes. Haskins andPierson (2016) analyzed the results of nine studies. Overall, theresults of this analysis were largely in favor ofbaccalaureate-prepared nurses.

Results showed that when patients were cared for by a greater numberof nurses who had completed baccalaureate programs, they showed alower risk of 30-day mortality. One of the individual studies actuallyshowed that for every 10% increase in the nurses who held abaccalaureate degree, the 30-day mortality rate reduced by 7% (Haskins& Pierson, 2016).

The authors also examined studies that looked at failure-to-rescueand BSN-prepared nurses. Hospitals with 20-29% and 30-39%baccalaureate degree nurses saw a reduction in failure-to-rescue by 9%and 8%, respectively. When hospitals had >40% baccalaureate nurses,there was a reduction of 18% seen in failure-to rescue (Haskins &Pierson, 2016). These results demonstrate that a baccalaureate degreein nursing has a positive effect on patient outcomes, specifically30-day mortality and failure-to-rescue (Haskins & Pierson, 2016).

In my personal experience, I do not agree with this research. Idon’t agree that a BSN is necessarily better than an ADN degree.I think that it matters more how dedicated the nurse is to learningand preparing him or herself. When I was in my clinical for nursingschool and as a new graduate nurse, I was frequently told by nurses atthe hospitals I was at that they actually preferred the ADN studentsover the BSN students because the ADNs were more dedicated to learningand working. I also work with many ADN nurses whom I would trust tocare for my family members or myself, and I’ve worked with BSNnurses that I would not give the same trust to. Obviously, that can bereversed also. However, the bottom line is that it cannot always bechalked up to a more expensive degree that makes a person a morecompetent nurse.

Haskins, S. and Pierson, K. (2016). The impact of the Bachelor ofScience in nursing (BSN) degree on patient outcomes: A systematicreview. Journal of Nursing Practice Applications & Reviews ofResearch, 6(1): 40-49. doi: http://dx.doi.org.lopes.idm.oclc.org/10.13178/jnpa…

Peer discussion 2

There are many paths to becoming a nurse whether it isobtaining
an associate’s degree or a bachelor’sdegree. Whether you obtain an ADN or BSN
you would start off inthe same level of practice within the nursing field and
have thesame patient responsibility, although some hospitals aretransitioning
to only hiring BSN nurses as studies show having ahigher level of education
such as a BSN correlates to improvedpatient care and health outcomes. In
research done at a hospitalin Pennsylvania, there was a link showing BSN
nurses were a 10%increase in proportion of nurses and this resulted in a
reductionof patient deaths by 5% (Robert Wood Johnson Foundation, 2014).

Based on my real life experiences, I do not agree withthese

findings. Additionally, going through the BSN program andalmost being done, I
know for a fact what I am learning here isnot going to improve my patient
care. Being educated does notimprove common sense and I feel like many nurses
who potentiallyinjure patients do so because they are careless or have no
commonsense and considering book smarts are different then common sense,there
is no correlation between patient safety and having a BSN.

Robert Wood Johnson Foundation. (2014). Building the Casefor

More Highly Educated Nurses. Retrieved from: https://www.rwjf.org/en/library/articles-and-news/…

Peer discussion 3

A cross-sectional study dating back to2013 found that RNs with BSN had better patient outcomes and a lowermortality rates in patients with CHF than nurses without a BSN.Another study in 2017 supports the idea that when comparing nurseswith an associate against nurses with a bachelors their ideas oneffective patient outcomes are different. Associate nurses focusmore on the local bedside level where as bachelor nurses focus moreat the systemic level including health care system factors likepolicy and staffing when it comes to patient safety.

When it comes to my real-lifeexperience I have noticed that nurses with BSN or MSN degrees are onthe unit they tend to spend more time in the chart or sitting behindthe desk rather than at the bedside. Now this comes down to theindividual I do not link a BSN/MSN to desk jobs, but I have noticedas of late new graduate RN’s who came from university do notthrive in the bed side setting like associate level nurses. I alsowant to point out that every associate level nurse I work with iscurrently enrolled to get their BSN myself included. So, while onlyholding an associate we are currently educating ourselves further tothat level of BSN. I truly do not see any correlation between thedegree being held and the level of care being provided to patients.If anything, personally these types of studies just divide nurses onthe unit as some many get attitudes with others due to level ofeducation achieved. I truly believe that when it comes down topatient safety as long as your heart and mind are in the right placepatient desired patient outcomes will be achieved regardless of degrees.

Reference:

Anbari, A. B., Vogelsmeier, A., &Dougherty, D. S. (2017). Patient safety communication amongdifferently educated nurses: Converging and diverging meaningsystems. Western Journal of Nursing Research. https://doi.org/10.1177%2F0193945917747600

Blegen, M. A., Goode, C. J., Park, S.H., Vaughn, T., & Spetz, J. (2013). Baccalaureate education innursing and patient outcomes. JONA: Journal of NursingAdministration, 43(2). https://doi.org/10.1097/NNA.0b013e31827f2028

Peer discussion 4

There are multiple paths you can take to become a RN, which is prettyunique in health care. In 2010 the IOM released a report in whichcalled for 80 percent of RNs to have their BSN by 2020. This has beena huge push in hospitals and is part of the gaining magnetrecognition. Research does support the claim that RNs with their BSNlead to improved patient outcomes, as opposed to ADNs. One study foundthat a 10 percent increase in proportion of RNs with BSNs wasconnected to a 7 percent decrease in patient deaths (RWJF, 2014).Research has supported this association and I do agree with this. BSNprograms better prepare nurses to care for the increasingly complexhealth care demands, with patients that are living longer, are sicker,and a lot have multiple comorbidities. BSN education includes muchmore critical thinking, complex problem solving, and leadership whichADN programs aren’t necessarily able to provide the students.Another study, which looked at more individual effect of patientsrather than the overall hospital numbers, found that “patientswho are cared for by a higher proportion of BSN-prepared nurses wereless likely to die, stayed in the hospital for shorter periods, andfaced lower health care costs” (RWJF, 2014). I know manyhospitals are willing to hire nurses with ADNs, but they do expect youto obtain your BSN within a few years, as well as most offeringtuition reimbursement after being employed there for so long. Theseare terms that are aimed to increase the number of employees withtheir BSN and promote the fulfillment of the IOMs goal and result inimproved patient outcomes.

References

Robert Wood Johnson Foundation (RWJF). (2014). Building the Case forMore Highly Educated Nurses. Retrieved from https://www.rwjf.org/en/library/articles-and-news/…

Peer discussion 5

Recent research studies have proven that obtaining abachelor’s degree in nursing is beneficial to the health andmortality of the patients entrusted to our care. Higher educationlevels significantly decrease patient mortality rates (Aiken,2010),and the American Association of Colleges of Nursing recently suggesteda higher level of education, “enhances both clinical competencyand care delivery” (AACN,2015). A higher level ofeducation decreases the risk for error, diminishes the possibility ofmissed care and promotes stronger critical thinking skills (Aiken,2010). Higher education also promotes confidence in nurses and thisconfidence is recognized by our patients.

Advancement is a great opportunity for registered nurses. ADNgraduates in acute care settings rarely advance to the role of nursemanager, nurse educator, or administration. These superior rolesgenerally require a higher level of education. The skills learnedduring the associates degree program do not focus on management. Forinstance, organizing the unit budget and cost effectiveness are notincluded in the ADN curriculum. Management skills are learned througha BSN approach, and these skills are only briefly mentioned during theADN program. Effective management is essential to quality patient careand unit survival. A productive work environment should be empoweringand capable of increasing morale among peers.

BSN education intensifies the understanding of patient-centered careand communication. A BSN nurse is more likely to be chosen as aresource nurse on any acute care unit. This is because a higher levelof education is desired and respected by upper management, patients,and peers. A resource nurse should knowledgeable, and capable ofcoming up with answers to difficult questions in a short period oftime. For example, one BSN nurse on my Palliative care unit, planned abeautiful wedding for a dying patient upon request. This nurse foundthe resources required to decorate the waiting room like a chapel,prepare a wedding cake, and locate a pastor who was willing to performthe ceremony. The couple wed three hours after the fiancéapproached nursing with their desire to marry before the patientpassed away. Leadership skills are the result of a highereducation. Effective leadership skills must be learned, and a leaderuses their skills to transform healthcare. Positive BSN leadershipcreates a caring foundation that accepts change and thrives on a challenge.

I agree that higher education enhances patient safety and decreasesmortality, but I believe we are overlooking one thing. ADN nurses areplaced under tremendous pressure to obtain their BSN. Most facilitieswho hire ADN nurses have them sign a contract which gives the nurse adeadline to complete their BSN. The push is for BSN nurses, soeverything is centered around the BSN nurse. As a profession, with thepush for BSN nursing, I think we often take the ADN nurse for granted.The associates degree is a stepping stone to the next level. I havesat in meetings where I have heard, “I will no longer hire ADNnurses”, or “ADN’s are not educated to understandresearch” or “ADN’s do not have the skills toprecept Capstone students”. This sends the message thatADN’s are suboptimal and can be traumatizing to the ADN nurse.ADN’s are far from suboptimal but if one hears this daily theywill begin to feel inferior and this will hinder patient care. As wegrow in our careers and earn higher education we need to remember ourroots. The pressure we place on each other is one of the greatestbarriers to effective patient care, and that is what we areoverlooking. As a BSN nurse we should guide our peers with associatesdegrees. We should encourage them and build up their confidence, sothey too will feel successful and earn their BSN willfully and without delay.

Aiken, L. Nurses for the future. (2010). N Engl JMed, 364 (3): pp 196-98.

American Association of Colleges of Nursing (2015). Creating a morehighly qualified nursing

work force. Retrieved from http://www.aacnnursing.org/News-Information/Fact-S…

Peer discussion 6

Time andtime again, research has shown that those who possess abachelor’s of science degree in nursing (BSN) improvespatient health and expected goal outcomes. shown thatpathways that lead to the bachelor’s degree in nursing(BSN) and higher may improve patient outcomes.Accordingto Robert Wood Johnson Foundation, hospitals that employ largernumbers of BSN-prepared nurses have lower patient mortality rates;reducing the probability of death by 5%. The link between nurseeducation and patient outcomes was confirmed in 2011(RWJF, 2014).I feel as though the research is biased in that it only supportsBSN nurses but it doesn’t state ‘why’ thedifference in rates. Do I believe that I am incapable of learningwhat a nurse with a BSN knows, the answer is no; but, I am awarethat society has placed emphasis on the continuance of education;therefore, the need for a BSN is imperative to me being merelyconsidered competent even before my skill is observed. I feel asthough if a nurse is dedicated to learning a trade and, orenhancing their skill that is what sets them apart and saveslives.Ithink that ADN nurses are not given the opportunity, especially atthis time, as a nurse who advances their degree; thus, they willnot be as knowledgeable as a BSN prepared nurse. However, iftaught and permitted to retain their current degree status, Ithink that they will be just as effective as the nurse whopossesses a BSN. I admit I have learned more in this program,however, the material was presented to me for me to learn. I thinkit is a matter of semantics – if the programs provided for ADNdegrees were widely accepted, then level of the degree would notmatter. Nurses are more and more being held at a higher standardand expected to perform at the highest level of their skill set.At times the duties fulfilled overlap and the practice of thenurse becomes more advanced. I truly believe the stipulationsbeing placed on delivery of patient care, as it relates to nursesoverall, is what has changed the mortality rate; it just sohappens that the nurses, because of requirements, were BSN nurses.

References

RobertWood Johnson Foundation. (2014, April 18). Building the Casefor More Highly Educated Nurses. Retrieved from Robert WoodJohnson Foundation: https://www.rwjf.org/en/library/articles-and-news/…